Transbronchial cryobiopsy in fibrosing interstitial lung disease: modifications of the procedure lead to risk reduction.
Lars HagmeyerDirk TheegartenJeremias WohlschlägerThomas HagerMarcel TremlSimon Dominik HerkenrathKhosro HekmatMatthias HeldweinWinfried J RanderathPublished in: Thorax (2019)
Sixty-one subjects with fibrosing interstitial lung disease were prospectively analysed to determine the efficacy of transbronchial cryobiopsy (CryoTBB) and the effect of procedural modifications which were introduced after an interim analysis of the first 19 subjects. The modifications significantly reduced complication rates from 84% to 14% (p<0.001). 30-day-mortality was 2%. The algorithm with initial CryoTBB and surgical lung biopsy (SLB) as optional step-up procedure was feasible. CryoTBB led to a confident diagnosis in 46/61 subjects (75%). Only 21% out of all subjects were forwarded for SLB. As the modified CryoTBB reduced but not eliminated the risk of severe complications, tissue sampling should be limited to patients where confident diagnosis enables life prolonging therapy. Trial registration number: NCT01714518.
Keyphrases
- interstitial lung disease
- systemic sclerosis
- rheumatoid arthritis
- idiopathic pulmonary fibrosis
- ultrasound guided
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- minimally invasive
- fine needle aspiration
- machine learning
- clinical trial
- cardiovascular events
- prognostic factors
- deep learning
- type diabetes
- phase iii
- bone marrow
- phase ii
- open label
- cell therapy