Bronchoscopic Cryotherapy. Clinical Applications of the Cryoprobe, Cryospray, and Cryoadhesion

DiBardino, David M.; Lanfranco, Anthony R.; Haas, Andrew R.

doi:10.1513/annalsats.201601-062fr

Cited by 85 publications

(77 citation statements)

References 76 publications

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“…Cryotherapy has multiple applications. It has been used in the multimodality approach to relieve benign and malignant CAO (90,(94)(95)(96). Dysplastic lesions and early, low-grade malignancies of the airways have been treated with cryotherapy with acceptable long-term control (97).…”

Section: Cryotherapy: Probe and Spraymentioning

confidence: 99%

Malignant central airway obstruction

Mudambi¹,

Miller²,

Eapen³

2017

J. Thorac. Dis.

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This review comprehensively describes recent advances in the management of malignant central airway obstruction (CAO). Malignant CAO can be a dramatic and devastating manifestation of primary lung cancer or metastatic disease. A variety of diagnostic modalities are available to provide valuable information to plan a therapeutic intervention. Clinical heterogeneity in the presentation of malignant CAO provides opportunities to adapt and utilize endoscopic technology and tools in many ways. Mechanical debulking, thermal tools, cryotherapy and airway stents are methods and instruments used to rapidly restore airway patency. Delayed bronchoscopic methods, such as photodynamic therapy (PDT) and brachytherapy can also be utilized in specific non-emergent situations to establish airway patency. Although data regarding the success and complications of therapeutic interventions are retrospective and characterized by clinical and outcome measure variability, the symptoms of malignant CAO can often be successfully palliated. Assessment of risks and benefits of interventions in each individual patient during the decision-making process forms the critical foundation of the management of malignant CAO.

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Section: Cryotherapy: Probe and Spraymentioning

confidence: 99%

Malignant central airway obstruction

Mudambi¹,

Miller²,

Eapen³

2017

J. Thorac. Dis.

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“…Upon expansion, the compressed liquid is converted to a gaseous state, creating a profound temperature drop. 20 This occurs on the basis of the Joule-Thomson effect. Nitrous oxide and carbon dioxide are the most commonly utilized cryogens and provide temperatures of -89 C and -79 C, respectively, within seconds at the tip of the cryoprobe.…”

Section: What Is Cryoablation?mentioning

confidence: 99%

“…Nitrous oxide and carbon dioxide are the most commonly utilized cryogens and provide temperatures of -89 C and -79 C, respectively, within seconds at the tip of the cryoprobe. 20,21 Cryoablation causes cell injury leading to necrosis and apoptosis through non-immune-mediated mechanisms. There is a "physical effect" due to the formation of intracellular ice crystals, which causes damage to cell membranes and organelles.…”

Section: What Is Cryoablation?mentioning

confidence: 99%

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Immunological Aspects of Cryoablation of Non–Small Cell Lung Cancer: A Comprehensive Review

Katzman

Sterman

2018

Journal of Thoracic Oncology

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In cryoimmunotherapy, target tumors are treated with cryoablation to generate antitumor immune responses. Because immune checkpoint inhibitors have demonstrated that lung cancer can be an immunotherapy-responsive disease, there has been renewed interest in the immunological aspects of cryoablation of lung cancer. Herein, we review preclinical and clinical trials of cryoablation of primary lung tumors. We examine the magnitude of cryoablation-induced antitumor immune responses and the synergy between cryoablation and either other immunotherapies or molecular targeted therapies to improve treatment responses in advanced lung cancer. We further discuss a rationale for the addition of cryoablation to immune checkpoint inhibitors for the treatment of advanced lung cancer, which is currently under clinical investigation.

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“…Cryotherapy is an evolving therapeutic and diagnostic tool used in bronchoscopy [ 1 ]. Conventional forceps transbronchial biopsy (TBB) obtains a relatively small amount of alveolar tissue, and the specimen has more artifacts in the alveolar part [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Radial Endobronchial Ultrasound-Guided Bronchoscopic Cryobiopsy without Fluoroscopy for Lung Parenchymal Lesions

Chang

Lee

et al. 2017

Canadian Respiratory Journal

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Background Cryobiopsy is used to biopsy peripheral lung lesions through flexible bronchoscopy with fluoroscopic guidance. However, fluoroscopy is not available at some institutions. This study evaluated the feasibility of radial endobronchial ultrasound-guided bronchoscopic cryobiopsy without fluoroscopy. Methods This retrospective study was conducted at Chang Gung Memorial Hospital, Linkou branch, in Taiwan. This study enrolled patients who received bronchoscopy examinations with cryotechnology between July 2014 and June 2016. The data were collected through medical chart review. Results During the study period, 101 patients underwent bronchoscopy examinations with cryotechnology. Ninety patients with endobronchial tumors were excluded from this study. Eleven patients who underwent radial endobronchial ultrasound-guided bronchoscopic cryobiopsy for lung parenchymal lesions were enrolled into this study. The mean age was 61.1 ± 13.8 years. Five patients were men, and the other six were women. The number of cryobiopsies ranged from 1 to 3. In the histological biopsies, the mean specimen diameter was 0.53 ± 0.23 cm, and the mean biopsy area was 0.20 ± 0.19 cm2. Nine of 11 patients had pathological diagnoses. No complications, including pneumothorax, respiratory failure, or major bleeding, were recorded after the procedure. Conclusions Endobronchial ultrasound is used to ensure biopsy location, and endobronchial ultrasound-guided cryobiopsy is a feasible technique to biopsy peripheral lung lesions in selected cases at institutions without fluoroscopy equipment. This study provided some rationale for further studies examining the impact of fluoroscopy.

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Bronchoscopic Cryotherapy. Clinical Applications of the Cryoprobe, Cryospray, and Cryoadhesion

Cited by 85 publications

References 76 publications

Malignant central airway obstruction

Malignant central airway obstruction

Immunological Aspects of Cryoablation of Non–Small Cell Lung Cancer: A Comprehensive Review

Feasibility of Radial Endobronchial Ultrasound-Guided Bronchoscopic Cryobiopsy without Fluoroscopy for Lung Parenchymal Lesions

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