Risk of bleeding associated with transbronchial biopsy using flexible bronchoscopy in patients with echocardiographic or chest CT evidence of pulmonary hypertension

Takashima, Yuta; Shinagawa, Naofumi; Morinaga, Daisuke et al.

BMC Pulmonary Medicine, 2023, 22(1), 449

Permalink : https://hdl.handle.net/2115/87815

このアイテムのアクセス数:368件（2026-01-23 20:06 集計）

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https://doi.org/10.1186/s12890-022-02245-y     4

論文情報

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アクセス権
metadata only access
URI
https://hdl.handle.net/2115/87815
タイトル
Risk of bleeding associated with transbronchial biopsy using flexible bronchoscopy in patients with echocardiographic or chest CT evidence of pulmonary hypertension
著者
Takashima, Yuta ; Shinagawa, Naofumi ; Morinaga, Daisuke ; Nakamura, Junichi ; Furuta, Megumi ; Shoji, Tetsuaki ; Asahina, Hajime ; Kikuchi, Eiki ; Kikuchi, Junko ; Sakakibara-Konishi, Jun ; Tsujino, Ichizo ; Konno, Satoshi
著者名
Takashima, Yuta
著者名
Shinagawa, Naofumi
著者名
Morinaga, Daisuke
著者名
Nakamura, Junichi
著者名
Furuta, Megumi
著者名
Shoji, Tetsuaki
著者名
Asahina, Hajime
著者名
Kikuchi, Eiki
著者名
Kikuchi, Junko
著者名
Sakakibara-Konishi, Jun
著者名
Tsujino, Ichizo
e-Rad_Researcher
20399835
著者名
Konno, Satoshi
言語
英語
キーワード
Bronchoscopy
Lung
EBUS
TBB
Echocardiography
Bleeding
Complication
Pulmonary hypertension
発行日
2023-11-28
出版者
BioMed Central
収録物名
BMC Pulmonary Medicine
巻(号)
22(1)
ページ
449
抄録
Background Endobronchial ultrasound (EBUS)-guided transbronchial biopsy (TBB) facilitates the diagnosis of various respiratory diseases. The safety of performing EBUS-guided TBB in patients with a finding of pulmonary hypertension (PH) is controversial. Little is known about the relationship between the risk of bleeding associated with EBUS-guided TBB in the presence of PH suspected on echocardiography or chest CT. Methods To assess the risk of bleeding associated with EBUS-guided TBB in patients with presumed PH per echocardiography or chest CT, we retrospectively reviewed the medical records of 314 consecutive patients who underwent EBUS-guided TBB using a guide sheath (GS), as well as echocardiography and chest CT. Bleeding complication was defined as over one minute of suctioning; repeated wedging of the bronchoscope; instillation of cold saline, diluted vasoactive substances, or thrombin due to persistent bleeding. Findings of suspected PH were defined as peak tricuspid regurgitation velocity (TRV) > 2.8 m/s on echocardiography or pulmonary artery to aorta ratio (PA:A ratio) > 0.9 on chest CT. Results In total, 35 (11.1%) patients developed bleeding, and all cases were managed safely. Furthermore, 17 (5.4%) and 59 (18.8%) patients were suspected to have PH based on echocardiography and chest CT, respectively. Among the patients suspected to have PH on echocardiography, five (5/17 = 29.4%) patients developed bleeding. Among the patients suspected to have PH on chest CT, 11 (11/59 = 18.6%) patients developed bleeding. Univariate analysis revealed that long diameter (>= 30 mm) of the lesion, lesion location (the biopsy site was inner than the segmental bronchus), bronchoscopic diagnosis of malignancy, and additional biopsy were potential predictive factors for bleeding. The finding of suspected PH on echocardiography correlated significantly with bleeding (p = 0.03). On multivariate analysis, long diameter (>= 30 mm) of the lesion (p = .021) and findings of suspected PH on echocardiography (p = .049) were significantly associated with bleeding. Conclusion All cases of bleeding in the present study were managed safely. The risk of bleeding is moderately elevated when PH is suspected by echocardiography in patients undergoing EBUS-guided TBB using a GS.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
PISSN
1471-2466
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1186/s12890-022-02245-y