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Safety and Efficacy of Expect TM 25 and 22 Gauge EBUS Needle
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A5009 - Safety and Efficacy of Expect TM 25 and 22 Gauge EBUS Needle
Author Block: S. Nuguru1, K. J. Diab2; 1Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, United States, 2Pulmonary and Critical Care Medicine, Indiana Univ School Of Med, Indianapolis, IN, United States.
Introduction: The Expect (TM) endobronchial ultrasound transbronchial aspiration needle is a cobalt chromium needle with a sharp tip designed for precise penetration into the target area and is more resilient over multiple passes into the lymph nodes. We examine the yield and complications of the 22 and 25-gauge Expect(TM) endobronchial ultrasound needles.
Methods: We retrospectively reviewed our prospectively collected database of endobronchial ultrasound guided transbronchial needle aspirations (EBUS-TBNA) performed with the ExpectTM 22 and 25-gauge needles performed at Indiana University Hospital over the last one year . Our main objectives were to assess the yield and specimen adequacy at different nodal stations using this needle, and to also look at procedure-related complications to both the patient and the bronchoscope.
Data Collection:Over a one year period, 102 patients underwent EBUS-TBNA using the Expect(TM) Needle. The 25-gauge needle was used in 22 cases and 22-gauge needle was used in 81 cases. Lymph nodes that were sampled included 2L,4R, 4L, 7, 10R, 10L, 11R, 11L, 12R , para-mediastinal masses and lung nodules. They ranged in size from 5mm to 11.7cm with most lymph nodes around 1 cm range. Preoperative indications were lymphadenopathy in 68 cases, lung masses in 41 cases, and lung nodules in 26 cases. 52 patients had a diagnosis of reactive lymph nodes and 35 had a diagnosis of metastatic cancer from multiple organs including lung( 29 ) , breast( 1) , renal (2) , seminoma(1) , melanoma(1) , esophagus (1) submandibular gland(1). The yield was 100% in all nodal stations . Mutational analysis was done in 32 cases with adequate analysis in 30 cases.In two cases involving 22 gauge needle , EGFR, KRAS was unable to be performed on cell block due to lack of tumor cells in one case and ROS and ALK could not be done due to insufficient quantity in the 2nd case . Positive mutations included ALK(3) , K-RAS(7),ROS-1(1) , BRAF-1(1) . PDL1 was adequate in all cases. One patient had pneumomediastinum for unknown reasons. We had 2 bronchoscope punctures on the same day when we used the needle without the stylet.
Conclusion: The ExpectTM 22 and 25-gauge needles are safe and effective when used for EBUS-TBNAs through the OlympusTM EBUS bronchoscope.
Author Block: S. Nuguru1, K. J. Diab2; 1Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, United States, 2Pulmonary and Critical Care Medicine, Indiana Univ School Of Med, Indianapolis, IN, United States.
Introduction: The Expect (TM) endobronchial ultrasound transbronchial aspiration needle is a cobalt chromium needle with a sharp tip designed for precise penetration into the target area and is more resilient over multiple passes into the lymph nodes. We examine the yield and complications of the 22 and 25-gauge Expect(TM) endobronchial ultrasound needles.
Methods: We retrospectively reviewed our prospectively collected database of endobronchial ultrasound guided transbronchial needle aspirations (EBUS-TBNA) performed with the ExpectTM 22 and 25-gauge needles performed at Indiana University Hospital over the last one year . Our main objectives were to assess the yield and specimen adequacy at different nodal stations using this needle, and to also look at procedure-related complications to both the patient and the bronchoscope.
Data Collection:Over a one year period, 102 patients underwent EBUS-TBNA using the Expect(TM) Needle. The 25-gauge needle was used in 22 cases and 22-gauge needle was used in 81 cases. Lymph nodes that were sampled included 2L,4R, 4L, 7, 10R, 10L, 11R, 11L, 12R , para-mediastinal masses and lung nodules. They ranged in size from 5mm to 11.7cm with most lymph nodes around 1 cm range. Preoperative indications were lymphadenopathy in 68 cases, lung masses in 41 cases, and lung nodules in 26 cases. 52 patients had a diagnosis of reactive lymph nodes and 35 had a diagnosis of metastatic cancer from multiple organs including lung( 29 ) , breast( 1) , renal (2) , seminoma(1) , melanoma(1) , esophagus (1) submandibular gland(1). The yield was 100% in all nodal stations . Mutational analysis was done in 32 cases with adequate analysis in 30 cases.In two cases involving 22 gauge needle , EGFR, KRAS was unable to be performed on cell block due to lack of tumor cells in one case and ROS and ALK could not be done due to insufficient quantity in the 2nd case . Positive mutations included ALK(3) , K-RAS(7),ROS-1(1) , BRAF-1(1) . PDL1 was adequate in all cases. One patient had pneumomediastinum for unknown reasons. We had 2 bronchoscope punctures on the same day when we used the needle without the stylet.
Conclusion: The ExpectTM 22 and 25-gauge needles are safe and effective when used for EBUS-TBNAs through the OlympusTM EBUS bronchoscope.
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