INTRODUCTION: Puncturing a lesion localized behind a vessel is considered as a contraindication for EBUS-TBNA. Although invasive, endobronchial ultrasound guided transvascular needle aspiration (EBUS-TVNA) seems to be reasonable alternative or even may occur the only option. Data about safety and efficacy of this technique is highly limited.

OBJECTIVES: A usefulness and safety profile of EBUS-TVNA for lung tumor diagnosis

METHODS: Retrospective analysis of EBUS-TVNA results. Considering risk-benefit ratio EBUS-TVNA was performed in selected cases, under conscious sedation, with no intubation. All biopsies were performed through interlobar or segmental pulmonary arteries. Patients were monitored for 24 hours after biopsy. Antibiotic prophylaxis and on site cytology were no used.

RESULTS: EBUS-TVNA was performed in 21 patients (8 females and 13 males) of mean age 71 in 5 centers over last year. Mean size of lesion was 32mm. BF-UC-190F EBUS scope (Olympus, Japan) and cytological 22G needles were used to biopsy lesions in left upper (7), lower (2), and right upper (8), middle (1) lower (3) lobe. NSCLC was found in 17 (81%) cases. Adenocarcinoma in 12 (70.6%) and material was suitable for IHC and molecular analysis in 15 (88.2%) of them. Silicoma and aspergilloma were diagnosed in one case each and 2 biopsies were non diagnostic. No procedure related complications including moderate or severe bleeding were noted.

CONCLUSIONS: EBUS-TVNA in carefully selected patients is a feasible alternative to more invasive procedures with a high yield. Appropriate monitoring and care must be available in the case of severe bleeding.