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K. J. Franke - One of the best experts on this subject based on the ideXlab platform.
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Transbronchial biopsy in comparison with Catheter Aspiration in the diagnosis of peripheral pulmonary nodules
Pneumologie (Stuttgart Germany), 2020Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Usually, transbronchial biopsy (TBB) is performed in the evaluation of bronchoscopically invisible solitary nodules and peripheral lesions of the lung. Additionally Catheter Aspiration can be done with the fiberbronchoscope, also under fluoroscopic guidance, to get cytological material. Despite of its simplicity, the Catheter Aspiration technique is widely unknown. In a prospective study we compared the diagnostic yield of both procedures concerning malignancy. 28 consecutive patients (age 69.4 +/- 8.9 years) underwent both TBB and Catheter Aspiration. The tumor size measured 41.4 +/- 14.5 mm. The frequency of TBB was 3.4 +/- 1.8 and of Catheter Aspiration 2.6 +/- 1.2 per patient. A malignant tumor was diagnosed in 13 cases by TBB and in 20 cases by Catheter Aspiration. With the combination of both methods, a malignancy was diagnosed in 23 cases. 3 of 5 bronchoscopically not malignant tumors turned out to be bronchial cancer by surgery, the other 2 were benign in a 2 year follow up. The diagnostic yield of Catheter Aspiration is significantly superior to transbronchial biopsy (77 % compared with 50 %, p < 0.05 chi square test). When combining both methods the result is further improved by about 10 %. Composed to of other cytological methods (transbronchial needle Aspiration, brush cytology) Aspiration by Catheter seems at least comparable, but with cost saving advantages.
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Transbronchial Catheter Aspiration and Transbronchial Needle Aspiration in the Diagnostic Workup of Peripheral Lung Lesions
Lung, 2015Co-Authors: K. J. Franke, G Nilius, Melanie Hein, Ulrike Domanski, Maik Schroeder, Jeremias Wohlschlaeger, Dirk TheegartenAbstract:Purpose Increasingly frequent, it is clinically indicated to obtain tissue from a peripheral lung lesion (PLL) to yield a pathological diagnosis. The aim of the present study was to evaluate the diagnostic sensitivity of transbronchial needle Aspiration (TBNA) and transbronchial Catheter Aspiration (TBCA) in addition to transbronchial forceps biopsy (TBB) at conventional bronchoscopy. Methods Eligible patients showing a PLL on computed tomography scans were included in the study. In all patients, following TBB, TBNA and TBCA were employed in randomised order under fluoroscopy. Results Fourty-eight patients were enrolled, of whom 46 patients with 46 PLLs were included in the analysis. The mean ± SD diameter of the PLL was 27.0 ± 13.3 mm. The overall sensitivity for all modalities was 69.6 %; PLL ≤20 or >20 and ≤30 mm in diameter showed a sensitivity of 60.0 and 72.2 %, respectively. For malignant PLL ( n = 33), the combined sensitivity of TBNA + TBCA versus TBB was significantly higher (63.6 vs. 33.3 %, p ≤ 0.05), and could not further be improved by TBB. For benign PLL, TBB was superior to TBNA + TBCA (76.9 vs. 38.5 %). Conclusions TBB, TBNA and TBCA are complementary to one another. Combining the three techniques, even allows transbronchial specimen collection of PLL
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Transbronchial Catheter Aspiration and Transbronchial Needle Aspiration in the Diagnostic Workup of Peripheral Lung Lesions
Lung, 2015Co-Authors: K. J. Franke, G Nilius, Melanie Hein, Ulrike Domanski, Maik Schroeder, Jeremias Wohlschlaeger, Dirk TheegartenAbstract:Purpose Increasingly frequent, it is clinically indicated to obtain tissue from a peripheral lung lesion (PLL) to yield a pathological diagnosis. The aim of the present study was to evaluate the diagnostic sensitivity of transbronchial needle Aspiration (TBNA) and transbronchial Catheter Aspiration (TBCA) in addition to transbronchial forceps biopsy (TBB) at conventional bronchoscopy.
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transbronchial Catheter Aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer
European Journal of Medical Research, 2009Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Objective The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial Catheter Aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy.
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Transbronchial Catheter Aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer
European Journal of Medical Research, 2009Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Objective The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial Catheter Aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy. Methods We analysed the results of 51 consecutively examined patients (age 68.7 ± 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 ≤ 3 cm. Fluoroscopy provided guidance in biopsies for both techniques. Results The mean diameter of the lesion was 3.7 ± 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma ≤ 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14). Conclusions Even in lesions ≤ 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.
G Nilius - One of the best experts on this subject based on the ideXlab platform.
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Transbronchial biopsy in comparison with Catheter Aspiration in the diagnosis of peripheral pulmonary nodules
Pneumologie (Stuttgart Germany), 2020Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Usually, transbronchial biopsy (TBB) is performed in the evaluation of bronchoscopically invisible solitary nodules and peripheral lesions of the lung. Additionally Catheter Aspiration can be done with the fiberbronchoscope, also under fluoroscopic guidance, to get cytological material. Despite of its simplicity, the Catheter Aspiration technique is widely unknown. In a prospective study we compared the diagnostic yield of both procedures concerning malignancy. 28 consecutive patients (age 69.4 +/- 8.9 years) underwent both TBB and Catheter Aspiration. The tumor size measured 41.4 +/- 14.5 mm. The frequency of TBB was 3.4 +/- 1.8 and of Catheter Aspiration 2.6 +/- 1.2 per patient. A malignant tumor was diagnosed in 13 cases by TBB and in 20 cases by Catheter Aspiration. With the combination of both methods, a malignancy was diagnosed in 23 cases. 3 of 5 bronchoscopically not malignant tumors turned out to be bronchial cancer by surgery, the other 2 were benign in a 2 year follow up. The diagnostic yield of Catheter Aspiration is significantly superior to transbronchial biopsy (77 % compared with 50 %, p < 0.05 chi square test). When combining both methods the result is further improved by about 10 %. Composed to of other cytological methods (transbronchial needle Aspiration, brush cytology) Aspiration by Catheter seems at least comparable, but with cost saving advantages.
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Transbronchial Catheter Aspiration and Transbronchial Needle Aspiration in the Diagnostic Workup of Peripheral Lung Lesions
Lung, 2015Co-Authors: K. J. Franke, G Nilius, Melanie Hein, Ulrike Domanski, Maik Schroeder, Jeremias Wohlschlaeger, Dirk TheegartenAbstract:Purpose Increasingly frequent, it is clinically indicated to obtain tissue from a peripheral lung lesion (PLL) to yield a pathological diagnosis. The aim of the present study was to evaluate the diagnostic sensitivity of transbronchial needle Aspiration (TBNA) and transbronchial Catheter Aspiration (TBCA) in addition to transbronchial forceps biopsy (TBB) at conventional bronchoscopy. Methods Eligible patients showing a PLL on computed tomography scans were included in the study. In all patients, following TBB, TBNA and TBCA were employed in randomised order under fluoroscopy. Results Fourty-eight patients were enrolled, of whom 46 patients with 46 PLLs were included in the analysis. The mean ± SD diameter of the PLL was 27.0 ± 13.3 mm. The overall sensitivity for all modalities was 69.6 %; PLL ≤20 or >20 and ≤30 mm in diameter showed a sensitivity of 60.0 and 72.2 %, respectively. For malignant PLL ( n = 33), the combined sensitivity of TBNA + TBCA versus TBB was significantly higher (63.6 vs. 33.3 %, p ≤ 0.05), and could not further be improved by TBB. For benign PLL, TBB was superior to TBNA + TBCA (76.9 vs. 38.5 %). Conclusions TBB, TBNA and TBCA are complementary to one another. Combining the three techniques, even allows transbronchial specimen collection of PLL
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Transbronchial Catheter Aspiration and Transbronchial Needle Aspiration in the Diagnostic Workup of Peripheral Lung Lesions
Lung, 2015Co-Authors: K. J. Franke, G Nilius, Melanie Hein, Ulrike Domanski, Maik Schroeder, Jeremias Wohlschlaeger, Dirk TheegartenAbstract:Purpose Increasingly frequent, it is clinically indicated to obtain tissue from a peripheral lung lesion (PLL) to yield a pathological diagnosis. The aim of the present study was to evaluate the diagnostic sensitivity of transbronchial needle Aspiration (TBNA) and transbronchial Catheter Aspiration (TBCA) in addition to transbronchial forceps biopsy (TBB) at conventional bronchoscopy.
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transbronchial Catheter Aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer
European Journal of Medical Research, 2009Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Objective The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial Catheter Aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy.
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Transbronchial Catheter Aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer
European Journal of Medical Research, 2009Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Objective The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial Catheter Aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy. Methods We analysed the results of 51 consecutively examined patients (age 68.7 ± 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 ≤ 3 cm. Fluoroscopy provided guidance in biopsies for both techniques. Results The mean diameter of the lesion was 3.7 ± 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma ≤ 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14). Conclusions Even in lesions ≤ 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.
Karl-heinz Rühle - One of the best experts on this subject based on the ideXlab platform.
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Transbronchial biopsy in comparison with Catheter Aspiration in the diagnosis of peripheral pulmonary nodules
Pneumologie (Stuttgart Germany), 2020Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Usually, transbronchial biopsy (TBB) is performed in the evaluation of bronchoscopically invisible solitary nodules and peripheral lesions of the lung. Additionally Catheter Aspiration can be done with the fiberbronchoscope, also under fluoroscopic guidance, to get cytological material. Despite of its simplicity, the Catheter Aspiration technique is widely unknown. In a prospective study we compared the diagnostic yield of both procedures concerning malignancy. 28 consecutive patients (age 69.4 +/- 8.9 years) underwent both TBB and Catheter Aspiration. The tumor size measured 41.4 +/- 14.5 mm. The frequency of TBB was 3.4 +/- 1.8 and of Catheter Aspiration 2.6 +/- 1.2 per patient. A malignant tumor was diagnosed in 13 cases by TBB and in 20 cases by Catheter Aspiration. With the combination of both methods, a malignancy was diagnosed in 23 cases. 3 of 5 bronchoscopically not malignant tumors turned out to be bronchial cancer by surgery, the other 2 were benign in a 2 year follow up. The diagnostic yield of Catheter Aspiration is significantly superior to transbronchial biopsy (77 % compared with 50 %, p < 0.05 chi square test). When combining both methods the result is further improved by about 10 %. Composed to of other cytological methods (transbronchial needle Aspiration, brush cytology) Aspiration by Catheter seems at least comparable, but with cost saving advantages.
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transbronchial Catheter Aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer
European Journal of Medical Research, 2009Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Objective The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial Catheter Aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy.
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Transbronchial Catheter Aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer
European Journal of Medical Research, 2009Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:Objective The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial Catheter Aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy. Methods We analysed the results of 51 consecutively examined patients (age 68.7 ± 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 ≤ 3 cm. Fluoroscopy provided guidance in biopsies for both techniques. Results The mean diameter of the lesion was 3.7 ± 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma ≤ 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14). Conclusions Even in lesions ≤ 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.
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Transbronchial Catheter Aspiration compared to forceps biopsy in the diagnosis of peripheral lung cancer
European journal of medical research, 2009Co-Authors: K. J. Franke, G Nilius, Karl-heinz RühleAbstract:OBJECTIVE The usual procedure for obtaining material for histological analysis for the diagnosis of peripheral carcinoma of the lung is transbronchial forceps biopsy (TBB). Not widely spread is acquiring samples for cytological examination by transbronchial Catheter Aspiration (TBCA). Data were retrospectively collected to determine the diagnostic sensitivity of TBCA in comparison with TBB concerning malignancy. METHODS We analysed the results of 51 consecutively examined patients (age 68.7 +/- 8.8 yrs.) applying both methods. 48 of 51 peripheral lesions proved to be malignant, 34 of which measured > 3 cm in diameter and 14 < or = 3 cm. Fluoroscopy provided guidance in biopsies for both techniques. RESULTS The mean diameter of the lesion was 3.7 +/- 1.5 cm. We were able to establish a correct diagnosis by TBCA in 36 of 48 patients with lung cancer, and in 21 of 48 patients by TBB (75% vs. 44%, p < 0.01, chi-square-test). By combination of both methods 39 of 48 patients were correctly diagnosed. For carcinoma > 3 cm the success rate for TBCA was 76% (26/34) and for TBB 56% (19/34). For carcinoma < or = 3 cm the success rate for TBCA was 71% (10/14) and for TBB 14% (2/14). CONCLUSIONS Even in lesions < or = 3 cm application of TBCA results in an only marginally lower success rate compared to lesions > 3 cm. Due to the overall high success rate we suggest to apply the easy-to-handle and inexpensive method of TBCA in diagnostic procedure of peripheral lung carcinoma.
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Verbreitung zytologischer Verfahren in der bronchoskopischen Diagnostik peripherer pulmonaler Herde
Pneumologie, 2006Co-Authors: Kj Franke, G Nilius, Karl-heinz RühleAbstract:Hintergrund: Durch Hinzunahme von Methoden zur Gewinnung zytologischen Materials zur transbronchialen Zangenbiopsie wird die Sensitivitat in der Diagnostik des peripheren Bronchialkarzinoms erhoht. Eine moglicherweise in Vergessenheit geratene effektive zytologische Technik stellt die transbronchiale KatheterAspiration dar. Zur Verbreitung zytologischer Verfahren sowie zum Stellenwert der transbronchialen KatheterAspiration im Vergleich zu transbronchialer NadelAspiration und Burstenabstrich fuhrten wir eine Umfrage durch. Methode: An samtliche 99 Pneumologische Kliniken in Deutschland mit zweijahriger Weiterbildungsermachtigung im Fach Pneumologie wurden Fragebogen gesandt. Ergebnisse: Wir erhielten einen Rucklauf von 70 Fragebogen (69 %). 79 % der Kliniken kombinieren die Zangenbiopsie mit zytologischen Methoden. Der Burstenabstrich stellt mit 51 % die am meisten verbreitete zytologische Technik dar gegenuber nur je 28 % fur die transbronchiale KatheterAspiration und die transbronchiale NadelAspiration. Bei regelmasiger Bronchiallavage durch 47 % der Untersucher fuhrt nur gut ein Viertel (27 %) regelhaft eine Imprintzytologie durch. Schlussfolgerungen: Der uberwiegende Anteil der befragten Kliniken setzt regelmasig kombiniert zytologische Verfahren ein, was aufgrund ihrer hohen Spezifitat und einer Erhohung der Trefferquote im Vergleich zur transbronchialen Zangenbiopsie alleine sinnvoll ist. Transbronchiale Katheter- und NadelAspiration finden relativ selten Verwendung, obwohl es sich hier um die einzigen zytologischen Verfahren mit einer signifikant hoheren Trefferquote als der der Zangenbiopsie handelt. Background: The combination of forceps biopsy and cytological methods improves the yield in diagnostic bronchoscopy of peripheral lung cancer. Transbronchial Catheter Aspiration seems to be an underutilized cytological technique, which is valuable and minimally invasive. We inquired for the frequency of cytological procedures and the importance of transbronchial Catheter Aspiration in comparison to transbronchial needle Aspiration and bronchial brushing. Methods: We sent questionnaires to 99 clinically practising and educating pulmonologists. Results: The response amounted to 69 %. Nearly 79 % of the pulmonologists usually combine forceps biopsy with cytological procedures. Instead of 51 % bronchial brushing, transbonchial Catheter Aspiration as well as needle Aspiration is the most applied cytological technique by only 28 % of the interrogated physicians. 47 % of the investigators practise bronchial washing and 27 % practise core roll preparations as a rule. Conclusions: Most of the specialized clinics in respiratory medicine in Germany add cytological methods to transbronchial forceps biopsy. This practice is pregnant with meaning because of a higher diagnostic yield while accuracy is likewise high. Unlike bronchial brushing transbronchial Catheter Aspiration and needle Aspiration are underutilized for different reasons in spite of the fact, that these are the only procedures with a significant higher sensitivity in comparison to forceps biopsy.
Dirk Theegarten - One of the best experts on this subject based on the ideXlab platform.
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Transbronchial Catheter Aspiration and Transbronchial Needle Aspiration in the Diagnostic Workup of Peripheral Lung Lesions
Lung, 2015Co-Authors: K. J. Franke, G Nilius, Melanie Hein, Ulrike Domanski, Maik Schroeder, Jeremias Wohlschlaeger, Dirk TheegartenAbstract:Purpose Increasingly frequent, it is clinically indicated to obtain tissue from a peripheral lung lesion (PLL) to yield a pathological diagnosis. The aim of the present study was to evaluate the diagnostic sensitivity of transbronchial needle Aspiration (TBNA) and transbronchial Catheter Aspiration (TBCA) in addition to transbronchial forceps biopsy (TBB) at conventional bronchoscopy. Methods Eligible patients showing a PLL on computed tomography scans were included in the study. In all patients, following TBB, TBNA and TBCA were employed in randomised order under fluoroscopy. Results Fourty-eight patients were enrolled, of whom 46 patients with 46 PLLs were included in the analysis. The mean ± SD diameter of the PLL was 27.0 ± 13.3 mm. The overall sensitivity for all modalities was 69.6 %; PLL ≤20 or >20 and ≤30 mm in diameter showed a sensitivity of 60.0 and 72.2 %, respectively. For malignant PLL ( n = 33), the combined sensitivity of TBNA + TBCA versus TBB was significantly higher (63.6 vs. 33.3 %, p ≤ 0.05), and could not further be improved by TBB. For benign PLL, TBB was superior to TBNA + TBCA (76.9 vs. 38.5 %). Conclusions TBB, TBNA and TBCA are complementary to one another. Combining the three techniques, even allows transbronchial specimen collection of PLL
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Transbronchial Catheter Aspiration and Transbronchial Needle Aspiration in the Diagnostic Workup of Peripheral Lung Lesions
Lung, 2015Co-Authors: K. J. Franke, G Nilius, Melanie Hein, Ulrike Domanski, Maik Schroeder, Jeremias Wohlschlaeger, Dirk TheegartenAbstract:Purpose Increasingly frequent, it is clinically indicated to obtain tissue from a peripheral lung lesion (PLL) to yield a pathological diagnosis. The aim of the present study was to evaluate the diagnostic sensitivity of transbronchial needle Aspiration (TBNA) and transbronchial Catheter Aspiration (TBCA) in addition to transbronchial forceps biopsy (TBB) at conventional bronchoscopy.
Jinok Jeong - One of the best experts on this subject based on the ideXlab platform.
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intracoronary Catheter Aspiration can be an adequate option in patients with acute myocardial infarction caused by left atrial myxoma
Journal of Cardiovascular Ultrasound, 2009Co-Authors: Hyung Seo Park, Jaehyeong Park, Jinok JeongAbstract:Cardiac myxomas are the most common benign cardiac tumors and can be associated with systemic embolization including acute myocardial infarction (AMI). The probability of an arterial embolization is closely related to a tumor's villous morphology. In cases of AMI caused by cardiac myxoma, open heart surgery including excision of the coronary artery has been the one of the treatment options for removing the myxoma and embolus from the coronary artery to maintain distal coronary flow. However, preparing for emergent open heart surgery takes a considerable amount of time. Moreover, this time delay can deteriorate the coronary perfusion to the infarcted area and is associated with poor clinical prognosis. So intracoronary Catheter Aspiration can be an additional option to maintain the distal coronary flow. In this report we present a case with acute anterior ST elevation myocardial infarction caused by a left atrial myxoma. The embolus in the left anterior descending coronary artery was successfully removed with intracoronary Catheter Aspiration, and distal coronary flow was restored after the procedure.