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First Combined Use of a Novel Flexible 21G Peripheral TBNA Needle and Ultrathin Bronchoscope in Patients with Peripheral Lung Lesions
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A7321 - First Combined Use of a Novel Flexible 21G Peripheral TBNA Needle and Ultrathin Bronchoscope in Patients with Peripheral Lung Lesions
Author Block: A. Sczaniecka1, R. F. Casal2, A. C. Chen3, H. X. Gonzalez4; 1Research, Spiration d/b/a ORA, Redmond, WA, United States, 2MD Anderson Cancer Ctr, Houston, TX, United States, 3Washington Univ School of Med, Saint Louis, MO, United States, 4Research, Spiration Inc, Redmond, WA, United States.
Introduction: The diagnostic yield of peripheral lesions is lower than that of central lesions. This is partially due to the lack of instrumentation capable of consistently reaching small targets in the periphery of the lungs and complicated by instrumentation exchanges.
Purpose: To evaluate the performance of a new flexible 21G peripheral transbronchial needle aspiration (TBNA) needle with an ultrathin bronchoscope in patients with peripheral lung lesions.
Methods: Pre-commercial flexible 21G peripheral TBNA needles (Olympus Respiratory America, Redmond, WA, USA) and a pre-commercial ultrathin bronchoscope with a 3.0 mm outer diameter and 1.7 mm working channel (Olympus Corporation, Tokyo, Japan) were provided to two US experienced centers. Between July 2017 and September 2017, physicians were asked to assess the performance of the needles in conjunction with the ultrathin scope and to complete evaluation forms. Physicians rated the ability of the needle and bronchoscope to reach and collect samples from the desired target locations.
Results: Three physicians sampled 25 targets in 25 patients with 25 needles. The needles were used in the following lung regions: 9 left upper lobe, 8 right upper lobe, 3 right lower lobe, 3 left lower lobe, and 2 right middle lobe. There were no adverse effects. Based on imaging, targets were on average 2.5 ± 1.0 cm in length and an average of 1.0 ± 0.9 cm from the pleura, with 24.0 % of targets directly contacting the pleura. Physicians used a radial endobronchial ultrasound probe in every case and fluoroscopy in 84.0% of cases. No guide sheath or catheter extension was used with the ultrathin scope. Physicians rated the ultrathin bronchoscope’s ability to reach the desired location as “Excellent” 92.0% and “Very Good” 8.0% of the time. Physicians rated the ability of the flexible needle to reach the desired target location as “Excellent” 80.0% and “Good” 20.0% of the time. In all cases physicians were able to collect a sample with the needle.
Conclusions: The novel flexible 21G Peripheral TBNA needle and ultrathin bronchoscope were able to reach a variety of peripheral target locations and collect adequate sample material, with minimal exchange of instrumentation. No complications were reported. Further clinical evaluations are warranted.
Author Block: A. Sczaniecka1, R. F. Casal2, A. C. Chen3, H. X. Gonzalez4; 1Research, Spiration d/b/a ORA, Redmond, WA, United States, 2MD Anderson Cancer Ctr, Houston, TX, United States, 3Washington Univ School of Med, Saint Louis, MO, United States, 4Research, Spiration Inc, Redmond, WA, United States.
Introduction: The diagnostic yield of peripheral lesions is lower than that of central lesions. This is partially due to the lack of instrumentation capable of consistently reaching small targets in the periphery of the lungs and complicated by instrumentation exchanges.
Purpose: To evaluate the performance of a new flexible 21G peripheral transbronchial needle aspiration (TBNA) needle with an ultrathin bronchoscope in patients with peripheral lung lesions.
Methods: Pre-commercial flexible 21G peripheral TBNA needles (Olympus Respiratory America, Redmond, WA, USA) and a pre-commercial ultrathin bronchoscope with a 3.0 mm outer diameter and 1.7 mm working channel (Olympus Corporation, Tokyo, Japan) were provided to two US experienced centers. Between July 2017 and September 2017, physicians were asked to assess the performance of the needles in conjunction with the ultrathin scope and to complete evaluation forms. Physicians rated the ability of the needle and bronchoscope to reach and collect samples from the desired target locations.
Results: Three physicians sampled 25 targets in 25 patients with 25 needles. The needles were used in the following lung regions: 9 left upper lobe, 8 right upper lobe, 3 right lower lobe, 3 left lower lobe, and 2 right middle lobe. There were no adverse effects. Based on imaging, targets were on average 2.5 ± 1.0 cm in length and an average of 1.0 ± 0.9 cm from the pleura, with 24.0 % of targets directly contacting the pleura. Physicians used a radial endobronchial ultrasound probe in every case and fluoroscopy in 84.0% of cases. No guide sheath or catheter extension was used with the ultrathin scope. Physicians rated the ultrathin bronchoscope’s ability to reach the desired location as “Excellent” 92.0% and “Very Good” 8.0% of the time. Physicians rated the ability of the flexible needle to reach the desired target location as “Excellent” 80.0% and “Good” 20.0% of the time. In all cases physicians were able to collect a sample with the needle.
Conclusions: The novel flexible 21G Peripheral TBNA needle and ultrathin bronchoscope were able to reach a variety of peripheral target locations and collect adequate sample material, with minimal exchange of instrumentation. No complications were reported. Further clinical evaluations are warranted.
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