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Keywords = TVNA

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18 pages, 311 KiB  
Review
Endobronchial Ultrasound Access to Pulmonary Vasculature in Thoracic Malignancy
by Evangelia Koukaki, Nektarios Anagnostopoulos, Aikaterini Bakiri, Stavroula Zaneli and Grigorios Stratakos
Cancers 2025, 17(4), 616; https://doi.org/10.3390/cancers17040616 - 11 Feb 2025
Viewed by 3080
Abstract
Endobronchial ultrasound (EBUS) has evolved beyond conventional applications in mediastinal staging and central pulmonary tumor diagnosis. It encompasses the assessment of pulmonary vasculature in patients with thoracic malignancies. EBUS can visualize major vessels and allow assessment of pulmonary embolism, differential diagnosis of endovascular [...] Read more.
Endobronchial ultrasound (EBUS) has evolved beyond conventional applications in mediastinal staging and central pulmonary tumor diagnosis. It encompasses the assessment of pulmonary vasculature in patients with thoracic malignancies. EBUS can visualize major vessels and allow assessment of pulmonary embolism, differential diagnosis of endovascular lesions, and T staging. Additionally, EBUS-guided transvascular needle aspiration (TVNA) has proven valuable for sampling lesions behind vessels and diagnosing conditions such as pulmonary artery sarcoma and tumor embolism, with low complication rates reported. The PubMed and SCOPUS databases were searched up to November 2024 for articles in the English language reporting the use of EBUS for pulmonary vasculature assessment. References were also searched for relevant articles. The integration of EBUS with other modalities enhances staging and diagnostic capabilities in thoracic malignancies. Despite promising findings, limitations include suboptimal image quality and challenges in extensively assessing all the vasculature. Safety concerns, particularly with transvascular biopsy, remain minimal with expert handling, although further studies are needed to assess specific risks like hematogenous tumor seeding. EBUS continues to evolve, suggesting its potential to become the cornerstone in advanced thoracic diagnostics and treatment planning. This review systematically explores the feasibility, safety, and diagnostic utility of EBUS in pulmonary vasculature assessment, highlighting its potential as an indispensable tool in thoracic diagnostics and treatment planning. Full article
(This article belongs to the Special Issue Screening, Diagnosis and Staging of Lung Cancer)
6 pages, 516 KiB  
Article
“To Do or Not to Do—That Is the Question”. Transvascular Needle Aspiration during EBUS (EBUS-TVNA) with Review of the Literature
by Arvind M. Perathur, Tinku Joseph, Sreeraj R. Nair and Umesh Varma
Adv. Respir. Med. 2021, 89(4), 386-391; https://doi.org/10.5603/ARM.a2021.0074 - 2 Sep 2021
Cited by 7 | Viewed by 1390
Abstract
Introduction: Large vessels are often encountered during endobronchial ultrasound (EBUS). Safety of traversing the vessels weighed against a more invasive procedure can be a dilemma. Material and methods: We describe a case series of 8 patients who underwent transvascular needle aspiration [...] Read more.
Introduction: Large vessels are often encountered during endobronchial ultrasound (EBUS). Safety of traversing the vessels weighed against a more invasive procedure can be a dilemma. Material and methods: We describe a case series of 8 patients who underwent transvascular needle aspiration during EBUS, to access a lesion in the absence of an alternate safe window. A 21 gauge EBUS needle was used to traverse either the main or a major branch of the pulmonary artery. Results: Malignancy was suspected at ROSE in five cases. Granuloma and necrosis noted in 2 cases were confirmed as tubercu-losis on culture. Diagnostic yield of EBUS-TVNA was 87.5% (7/8). No complications were noted in the immediate post-operative period as well as during 6 months of follow up. Conclusion: EBUS-TVNA in carefully selected patients is a feasible alternative to more invasive procedures with excellent yield. Appropriate intraoperative, perioperative and postoperative monitoring and care must be available in the case of fatal bleeds. Full article
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