Cryobiopsy Flashcards
What are the recommended procedures for cryobiopsy in ILD?
1cm from the pleura
2 different areas (increased yield) either subsegments or lobes
Use of fluoroscopy
Use of a bronchial blocker
Either ETT or rigid is acceptable
Use of 1.9mm vs 2.4mm cryoprobe (increased tactile feedback and easier maneuvering)
What is the risk of pneumothorax with cryobiopsy for ILD?
One site 15.2%
Multiple sites 24.6%
Pooled average from multiple studies (9.5%)
What is the mortality rates for SLB for ILD?
Elective procedures 1.7%
Nonelective 16%
What are the advantages of cryobiopsy over SLB for ILD?
Lower mortality (0.3% vs average of 2.7%)
Lower risk of exacerbation (0.3% vs 3.3%)
Reduced hospitalization time (2.6 vs 6.1 days)
What is the rate of severe bleeding from cryobiopsy for ILD?
1.1%
What is the difference in yield when comparing two vs one segment for cryobiopsy in ILD?
92.5% vs 84.8%
What is the difference between small and large cryoprobes in cryobiopsy for ILD?
Reduced pneumothorax rate 2.7% vs 21.2%
Same bleeding and diagnostic rates
What are contraindications to cryobiopsy for ILD?
Relative:
Aspirin
PASP >50 on TTE
Absolute:
Severely abnormal coagulation studies
PY-12 inhibitors
Thrombocytopenia <50k
Active anticoagulation
What are the recommendations for cryobiopsy in suspected fibrotic hypersensitivity pneumonitis?
CAN-ICE showed that cryobiopsy may be insufficient for differentiating between IPF and fHP (small sample size and less biopsy samples may have limited this trial)
