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Endobronchial Ultrasound-Guided Transvascular Needle Aspiration (EBUS-TVNA), Ten Years of Experience and Success
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A7323 - Endobronchial Ultrasound-Guided Transvascular Needle Aspiration (EBUS-TVNA), Ten Years of Experience and Success
Author Block: M. M. Rachid, E. Mekhaiel; Internal Medicine, UIC/Advocate Christ Medical Center, Oak Lawn, IL, United States.
Introduction: The endobronchial ultrasound-guided trans-bronchial needle aspiration (EBUS-TBNA) is a very useful tool in the diagnosis of lung cancer. EBUS-TBNA is now the procedure of choice in the evaluation of any mediastinal abnormalities, lymphadenopathy and in the staging of lung cancer per lung cancer guidelines . It is a fairly safe procedure with rare reported complications. Lymph node stations that are easily accessible through EBUS-TBNA are 2, 4,10, 11 and 12 on both sides and station 7. Stations 5 and 6 are not accessible as they are anatomically located in front of the aortic arch and pulmonary artery. Obtaining tissue from station 5 lymph node endoscopically requires traversing the pulmonary artery. This is new procedure is known as Endobronchial Ultrasound-guided Transvascular Needle Aspiration (EBUS-TVNA) Twenty three cases of EBUS-TVNA were previously reported. We recently had an additional case. We reviewed all of these cases to assess effectiveness and safety of this approach. Methods: We obtained the demographic features of these patients, the lymph node station, lung nodule/mass location, side of the lymph node, size of the lymph node or the lung lesion, whether or not the procedure was diagnostic and reported complications from these 24 cases. Results: Out of the 24 included cases, 13 (54.16%) cases were done at lymph nodes station 5, 2 (8.33%) cases were done at station 10, 2 (8.33%) at station 11, 1 (4.16%) at station 12 and 6 (25.00%) were nodules or masses of nonspecific lymph nodes station. Out of the 24 cases, the EBUS-TBNA was definitive and diagnostic in 22 (91.66%) cases and non definitive in 2 (8.33%) cases. For these two cases, the first one was diagnosed with Histoplasmosis through video-assisted thoracoscopic surgery (VATS) and the second one ended up having chamberlain procedure which was diagnostic for non-small cell lung cancer. None of the 24 reported cases had any complications either during or after the procedures. Conclusion: EBUS-TBNA is an accurate and safe procedure in staging and diagnosing lung cancer. EBUS-TBNA through the pulmonary artery, which is called TBNA-TVNA, showed high accuracy without major complications in all 24 cases reported. An experienced operator, real-time guidance, low pressure circulation of pulmonary circulation and small-diameter needles are contributing factors of the safety of this promising approach.
Author Block: M. M. Rachid, E. Mekhaiel; Internal Medicine, UIC/Advocate Christ Medical Center, Oak Lawn, IL, United States.
Introduction: The endobronchial ultrasound-guided trans-bronchial needle aspiration (EBUS-TBNA) is a very useful tool in the diagnosis of lung cancer. EBUS-TBNA is now the procedure of choice in the evaluation of any mediastinal abnormalities, lymphadenopathy and in the staging of lung cancer per lung cancer guidelines . It is a fairly safe procedure with rare reported complications. Lymph node stations that are easily accessible through EBUS-TBNA are 2, 4,10, 11 and 12 on both sides and station 7. Stations 5 and 6 are not accessible as they are anatomically located in front of the aortic arch and pulmonary artery. Obtaining tissue from station 5 lymph node endoscopically requires traversing the pulmonary artery. This is new procedure is known as Endobronchial Ultrasound-guided Transvascular Needle Aspiration (EBUS-TVNA) Twenty three cases of EBUS-TVNA were previously reported. We recently had an additional case. We reviewed all of these cases to assess effectiveness and safety of this approach. Methods: We obtained the demographic features of these patients, the lymph node station, lung nodule/mass location, side of the lymph node, size of the lymph node or the lung lesion, whether or not the procedure was diagnostic and reported complications from these 24 cases. Results: Out of the 24 included cases, 13 (54.16%) cases were done at lymph nodes station 5, 2 (8.33%) cases were done at station 10, 2 (8.33%) at station 11, 1 (4.16%) at station 12 and 6 (25.00%) were nodules or masses of nonspecific lymph nodes station. Out of the 24 cases, the EBUS-TBNA was definitive and diagnostic in 22 (91.66%) cases and non definitive in 2 (8.33%) cases. For these two cases, the first one was diagnosed with Histoplasmosis through video-assisted thoracoscopic surgery (VATS) and the second one ended up having chamberlain procedure which was diagnostic for non-small cell lung cancer. None of the 24 reported cases had any complications either during or after the procedures. Conclusion: EBUS-TBNA is an accurate and safe procedure in staging and diagnosing lung cancer. EBUS-TBNA through the pulmonary artery, which is called TBNA-TVNA, showed high accuracy without major complications in all 24 cases reported. An experienced operator, real-time guidance, low pressure circulation of pulmonary circulation and small-diameter needles are contributing factors of the safety of this promising approach.
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