Background

Transbronchial lung cryobiopsy (TBLC) is a diagnostic procedure for interstitial lung diseases (ILD). It is safer than surgical lung biopsy, but it is still associated with complications: haemorrhage and pneumothorax mainly.

Aim

To evaluate TBLC complications according to the radiological pattern (fibrotic versus non-fibrotic).

Methods

Observational, descriptive and retrospective study of patients who required TBLC during 2012-2022.

Results

294 patients were included, 71.8% females, age 60.8 y/o (±12.9), FVC 88.7%(±22%) and DLCO 62.6%(±20.1%). 108(36.7%) had fibrotic pattern in CT scan and 186(63.3%) non-fibrotic pattern. Although median DLCO was lower in fibrotic ILD (58.2%±17.8 vs. 65.1%±21, p<0.05), pulmonary artery pressure (PAP) did not differ between groups (33.90mmHg (±7.1) vs. 33.65mmHg(±9.57)(p=0.9).

Mild bleeding occurred in 22(7.5%), moderate in 2(7.1%) and severe in 3(1%). Moderate and severe bleeding did not significantly differ according to radiological pattern (6.5% in fibrotic and 9.1% in non-fibrotic ILD (p=0.42)), estimated PAP (9.5% in PAP>40mmHg and 13.4% in PAPs<40mmHg,p=0.64) or DLCO (7.9% with DLCO>60% and 7.3% with DLCO<60%,p=0.9).

Pneumothorax occurred in 16(5.5%), requiring pleural drainage in 7(43.8%). Pneumothorax did not significantly differ according to radiological pattern (8(7.4%) in fibrotic and 8(4.3%) in non-fibrotic ILD,p=0.24), presence of emphysema (4(6.7%) vs. 12(5.2%),p=0.65).

1-month mortality after procedure was 1.6% (3 patients). 

Conclusions

We did not find a relation between TBLC complications according to radiological pattern, DLCO, PAP or presence of emphysema. Our findings suggest that none of these variables should contraindicate TBLC.