Single Center Experience With a New Guiding Catheter in Electromagnetic Navigation Bronchoscopy

Abstract

PURPOSE: Electromagnetic navigation bronchoscopy has shown to improve the yield for the diagnosis of peripheral pulmonary nodules. We intend to document our single center experience during the first year of use of a new guiding catheter using this technology. METHOD(S): This is a retrospective chart review of the first 20 adult patients that have undergone electromagnetic navigation bronchoscopy at UMass. Procedures were done by one of three interventional pulmonologists. All three bronchoscopists had undergone prior training in electromagnetic navigation bronchoscopy. The system used was the i-LogicTM (SuperDimension, Ltd. Minneapolis, MN) with a new EdgeTM catheter which includes a curved tip of 45, 90, and 180 degree angles chosen depending on the location of the lesion. Needle-brushings, biopsies, and mini-bronchoalveolar lavage was performed after navigation to the target lesion. Fluoroscopy and radial ultrasound were also used to confirm correct localization. We recorded the location and width of the nodules, quality of 3D mapping, complications, and final diagnosis. RESULT(S): In all cases, navigation to the target nodule was performed successfully. The location of the nodules was relatively evenly distributed. The mean width of the nodules was 15 mm (SD +/- 8 mm) with a median of 14 mm. The quality of the 3D map was good in 65% of the cases. There were no complications noted. A diagnosis of malignancy was made in 45% of the cases, while the remainder were non-diagnostic. CONCLUSION(S): In our first year of use of a new guiding catheter for electromagnetic navigation bronchoscopy, our diagnostic yield was 45%. No complications were noted. Navigation to the lesion was not a problem. Our lower than historical yields may be related to case selection, lesion size, and sampling methods.