Endobronchial cryobiopsy / endobronchial debulking for recanalization
Obstructing central airway tumor
Even with the combination of different sampling techniques (forceps, brush, needles, etc.) you cannot reach the diagnostic rate of cryobiopsy alone in endobronchial lesions.
In up to 91% of cases, you can restore airway patency by debulking an endobronchial tumor with cryotechnology – even in patients who cannot tolerate a lower FiO2.
Unlike other biopsy techniques, you can increase the detection rate of activating EGFR mutations in NSCLC with bronchoscopic cryobiopsy.
In terms of safety cryotechnology is superior to laser in bronchoscopic therapy of endobronchial tumors.
Treat bleeding with APC if it occurs after debulking lesions with cryotechnology.
Achieve hemostasis with APC around curvatures or tumor margins.
You can reach a favorable safety profile and a quicker learning curve with APC in bronchoscopy compared to laser applications.
Application videos
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Endobronchial cryobiopsies with the 2.4 mm single-use probe
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Removal of a lung tumor with monopolar snare, flexible single-use cryoprobe and APC
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Recanalization with 1.7mm single-use cryoprobe
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Indications for endobronchial cryobiopsy & cryotherapy
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Contraindications for endobronchial cryobiopsy & cryotherapy
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Bleeding management for endobronchial cryobiopsy & cryotherapy
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How to mitigate perforation risk when performing endobronchial cryoextraction?
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Recanalization of endobronchial tumor with APC 2
Scientific information
Summary of publication
Hetzel J, et al: Cryobiopsy increases the diagnostic yield of endobronchial biopsy: a multicentre trial. Eur Respir J. 2012 Mar;39(3):685-90.
In this randomized multicenter study, the authors compared cryobiopsy and conventional forceps sampling for diagnosis of endobronchial malignancies. 281 patients were randomized to receive endobronchial biopsies with forceps, and 282 had biopsies performed with a flexible cryoprobe. After obtaining biopsy samples, a blinded histological evaluation was performed. A definitive diagnosis was achieved in significantly more patients who underwent cryobiopsy (95.0%) than in those randomized to conventional forceps biopsy (85.1%, p<0.001), even though there was no difference in the incidence of significant bleeding. The authors concluded that ‘Endobronchial cryobiopsy is a safe technique with superior diagnostic yield in comparison with conventional forceps biopsy.’
Ehab A, et al: Cryobiopsy versus forceps biopsy in endobronchial lesions, diagnostic yield and safety. Adv Respir Med. 2017;85(6):301-306.
This study aimed to evaluate the safety and diagnostic yield of cryobiopsy compared with forceps biopsy in endobronchial lesions. Two forceps biopsies and one cryobiopsy (reusable cryoprobe, 2.4mm) were taken from the same patient in a randomized sequence. Samples obtained with cryobiopsy were significantly larger than those obtained with forceps biopsy (5.9mm ± 2.3 vs 2.5mm ± 0.8, p = 0.001). The diagnostic yield of cryobiopsy was significantly higher than that with forceps biopsy (74.5% versus 51.1%, p = 0.001). Mild and moderate grades of bleeding were reported in both techniques, with no significant difference and no severe bleeding. The authors concluded that ‘Cryobiopsy represents a safe and effective tool to obtain larger tissue samples of good quality, with higher diagnostic yield in comparison to standard forceps samples. However, bleeding occurred more frequently after cryobiopsy than with forceps biopsy, but without severe adverse effects.’
