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Use of a Novel Flexible 21G Peripheral TBNA Needle for Sampling in the Lung Periphery

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A7318 - Use of a Novel Flexible 21G Peripheral TBNA Needle for Sampling in the Lung Periphery
Author Block: R. Kruklitis1, A. Sczaniecka2, H. X. Gonzalez3; 1Department of Medicine, Lehigh Valley Health Network, Allentown, PA, United States, 2Spiration d/b/a Olympus Respiratory America, Redmond, WA, United States, 3Research, Spiration Inc, Redmond, WA, United States.
Introduction: There is a need of flexible needles that can reach the periphery of the lung for sampling without distorting the position of the bronchoscope and/or guide sheath.
Purpose: To evaluate the performance of a new flexible 21G peripheral transbronchial needle aspiration (TBNA) needle in a single medical center.
Methods: A pre-commercial flexible 21G peripheral TBNA needles (Olympus Respiratory America, Redmond, WA, USA) was evaluated in our center which has experience performing peripheral sampling. Between May 2017 and September 2017, needles were used in a variety of patients requiring sampling of peripheral lesions. After each needle use, data was collected into an evaluation form.
Results: Eighteen targets were sampled in 18 patients with 18 needles. In all cases, the flexible needles reached the target locations and collected samples. The needles were used in the following lung regions: 6 in the left upper lobe, 4 in the right upper lobe, 4 in the left lower lobe, 3 in the right middle lobe, and 1 in the right lower lobe. There were no adverse effects. Planning was done using CT analysis only in all cases. Based on imaging, targets were on average 1.9 ± 0.6 cm in length and an average of 1.4 ± 0.9 cm from the pleura. Three different types of bronchoscopes were used. Radial endobronchial ultrasound (EBUS) probe was used in 89% of cases and fluoroscopy in 67% of cases. A guide sheath was used in 22% of cases. Besides the needles, biopsy forceps were used in 61% of cases, brush in 67% of cases and lavage / washing in 72% of cases. The diagnostic yield in this series was 61%Our assessment regarding the performance of the needles to reach the desired target location was “Excellent” 50% and “Good” 44% of the time.
Conclusions: This novel flexible 21G Peripheral TBNA needle was able to reach and collect samples in a variety of peripheral target locations. No complications were observed. This needle was an excellent complement to biopsy and brush sampling. Additional clinical evaluations are warranted.
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