Feasibility and Safety of Endosonography-Guided Transvascular Needle Aspiration in the Diagnosis of Thoracic and Abdominal Lesions: A Meta-Analysis

Interventional Pulmonology

Yang H.a· Yang W.b· Zhang X.a· Zhang Q.a· Wang Z.a· Chen C.c· Herth F.J.F.d,e

Author affiliations

aDepartment of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
bDepartment of Anesthesiology, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
cClinical Bioinformatics Experimental Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
dDepartment of Pneumology and Respiratory Care Medicine, Thoraxklinik Heidelberg, Heidelberg, Germany
eTranslational Lung Research Center Heidelberg, University of Heidelberg, Heidelberg, Germany

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Article / Publication Details

First-Page Preview

Abstract of Interventional Pulmonology

Received: July 12, 2022
Accepted: December 01, 2022
Published online: January 16, 2023

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Background: Endoscopic techniques, including endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS), are used as the initial approach for the diagnosis and staging of lung cancer and the diagnosis of thoracic and abdominal lesions. Historically, the transvascular approach has been avoided because of concerns about bleeding. Objectives: This article is a systematic review of studies evaluating the feasibility and safety of transvascular needle aspiration (TVNA) under the guidance of EBUS or EUS in the diagnosis of thoracic and abdominal lesions. Methods: We performed a systematic search of the MEDLINE, Embase, and Cochrane databases to identify studies evaluating the application of EBUS/EUS-guided TVNA (EBUS/EUS-TVNA) for lesions located at the contralateral side of the vessel for which the transvascular approach was the best puncture path. We performed a meta-analysis of diagnostic yield estimations. We also reviewed the complications related to the procedure. Results: Eleven observational studies were included in the final analysis. Meta-analysis yielded a pooled overall diagnostic yield of 82.10% (95% confidence interval, 0.74–0.89) for TVNA, with an I2 value of 52%. No publication bias was detected by Egger’s test (p = 0.8528). The overall complications included minor bleeding, minor hematoma, pseudo­aneurysm of the aorta, hemoptysis, acute hypoxic respiratory failure, and moderate bleeding. The major complication rate was 2.71%. Conclusions: EBUS/EUS-TVNA is feasible and probably safe when performed by experienced endoscopists in carefully selected patients. In view of the potential risks associated with the transvascular approach, especially the development of hematoma and pseudoaneurysm, the fanning technique was avoided, and the area of aspiration should be assessed by EUS for 3 min after each aspiration. Most importantly, EBUS/EUS-TVNA should only be performed if the results will impact the clinical management.

© 2023 S. Karger AG, Basel

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First-Page Preview

Abstract of Interventional Pulmonology

Received: July 12, 2022
Accepted: December 01, 2022
Published online: January 16, 2023

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

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