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Initial Clinical Experience With a Flexible Peripheral 21-G Needle Device

Tremblay, Alain, MDCM*; Myers, Renelle, MD; Beaudoin, Eve-Lea, MD; Bonifazi, Martina, MD; Delage, Antoine, MDCM§; Fortin, Marc, MD§; Hergott, Christopher A., MD*; MacEachern, Paul R., MD*; Shaipanich, Tawimas, MD; Shieh, Benjamin, MD*; Gasparini, Stefano, MD; Lam, Stephen, MD

Journal of Bronchology & Interventional Pulmonology: October 2018 - Volume 25 - Issue 4 - p 346–348
doi: 10.1097/LBR.0000000000000505
Brief Reports

Background: Bronchoscopic techniques can be used to safely sample peripheral lung nodules (PLN), and transbronchial needle aspiration (TBNA) can further increase the diagnostic yield. Current needle devices not necessarily designed for this indication have limitations. We report our initial experience with a new flexible nitinol peripheral TBNA needle specifically designed for such sampling.

Methods: Retrospective case review describing the first clinical cases performed with a commercially available 21-G peripheral TBNA device in 4 centers.

Results: Eleven different operators performed 40 procedures for PLNs of a mean size of 35.1 mm (±18), and located 18.8 mm (±18.8) from the pleural surface, with 50% of them being present in the upper lobes. Bronchoscopists rated the use of the needle as good or excellent for reaching the PLN in 27/30 (90%) of cases. The TBNA sample was diagnostic in 18/40 cases (45%) overall and in 18/28 (64.3%) of cases where a diagnosis on bronchoscopy was possible. No episode of pneumothorax, significant bleeding, hypoxemia, escalation of care, or other complications were noted.

Conclusion: Our initial experience with a novel peripheral TBNA device appears safe and effective, and may offer technical advantages over other available devices. Additional studies will be required to confirm the role of this device in the approach to bronchoscopic sampling of parenchymal lung nodules.

*Department of Medicine, University of Calgary, Calgary, AB

Department of Medicine, University of British Columbia, Vancouver, BC, Canada

§Institut Universitaire de Cardiologie et pneumologie de Québec, Quebec City, QC, Canada

Department of Internal Medicine, Università Politecnica delle Marche, Ancona, Italy

The 40 TBNA needle devices were supplied free of charge by Olympus Respiratory America as part of a product evaluation program.

Disclosure: A.T. has received consulting fees from Olympus Respiratory America for product development consulting and continuing medical education events. A.D. has performed contract research for Olympus Respiratory America. The remaining authors have no conflict of interest or other disclosures.

Reprints: Alain Tremblay, MDCM, 3330 Hospital Drive NW, Calgary, AB, Canada T2N4N1 (e-mail:

Received December 15, 2017

Accepted February 26, 2018

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