PT  - JOURNAL ARTICLE
AU  - Lars Hagmeyer
AU  - Dirk Theegarten
AU  - Jeremias Wohlschläger
AU  - Thomas Hager
AU  - Marcel Treml
AU  - Simon Dominik Herkenrath
AU  - Khosro Hekmat
AU  - Matthias Heldwein
AU  - Winfried J Randerath
TI  - Transbronchial cryobiopsy in fibrosing interstitial lung disease: modifications of the procedure lead to risk reduction
AID  - 10.1136/thoraxjnl-2018-212095
DP  - 2019 Mar 09
TA  - Thorax
PG  - thoraxjnl-2018-212095
4099  - http://thorax.bmj.com/content/early/2019/03/08/thoraxjnl-2018-212095.short
4100  - http://thorax.bmj.com/content/early/2019/03/08/thoraxjnl-2018-212095.full
AB  - Sixty-one subjects with fibrosing interstitial lung disease were prospectively analysed to determine the efficacy of transbronchial cryobiopsy (CryoTBB) and the effect of procedural modifications which were introduced after an interim analysis of the first 19 subjects. The modifications significantly reduced complication rates from 84% to 14% (p<0.001). 30-day-mortality was 2%. The algorithm with initial CryoTBB and surgical lung biopsy (SLB) as optional step-up procedure was feasible. CryoTBB led to a confident diagnosis in 46/61 subjects (75%). Only 21% out of all subjects were forwarded for SLB. As the modified CryoTBB reduced but not eliminated the risk of severe complications, tissue sampling should be limited to patients where confident diagnosis enables life prolonging therapy. Trial registration number: NCT01714518.