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Medical Thoracoscopy

Exsudative pleural effusion of unknown origin

  • Extract deeper tissue samples with pleural cryobiopsy than is possible with standard forceps and achieve higher accuracy of disease staging (especially with mesothelioma).

  • Pleuroscopic cryobiopsy during flex-rigid pleuroscopy is an effective, safe and convenient technique suitable for immunohistochemical and molecular analyses for malignant pleural mesothelioma diagnosis.

  • Reduce the histological finding of nonspecific pleuritis to contribute to your definitive therapeutic decision in a larger fraction of patients.

  • Quickly and easily avoid the difficulties of diffusely thickened and fibrotic pleural nodes that often occur with the lift-and-peel technique with forceps.

  • APC offers you a faster learning curve and a better safety profile than is possible with laser treatment.

Application videos

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Pleuroscopic cryobiopsies using the flexible 1.7 mm single-use cryoprobe with ERBECRYO® 2

Scientific information

Summary of publication

Dhooria, Sahajal et al: (2019): Pleural Cryobiopsy versus Flexible Forceps Biopsy in Subjects with Undiagnosed Exudative Pleural Effusions Undergoing Semirigid Thoracoscopy: A Crossover Randomized Trial (COFFEE Trial). Respiration; international review of thoracic diseases 98 (2), S. 133–141.
 

In this prospective study cryobiopsy (reusable, 2.4mm) and flexible forceps biopsy were compared for the diagnosis of pleural effusion in medical thoracoscopy. The same patients (n=50) underwent both forceps and cryobiopsy in a randomized order using semirigid thoracoscopy. Cryobiopsy specimens were significantly larger (median size 7.0mm vs. 4.0mm; p < 0.001) and had a significantly greater depth (down to the pleural fat or deeper: 65.2 vs. 40.8%; p = 0.02) than specimens from forceps biopsy. The duration of the cryobiopsy procedure was also significantly shorter than that of forceps biopsy (median duration 10 vs. 15 min; p < 0.001). The diagnostic yield (78.0% vs. 76.0%), difficulty of performing the biopsy, and severity of bleeding were similar in the two procedures. The authors concluded that “The diagnostic yield of pleural cryobiopsy was comparable to forceps biopsy during semirigid thoracoscopy.”
 

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Summary of publication

Botana Rial, Maribel et al: (2020): Diagnostic Yield and Safety of Pleural Cryobiopsy during Medical Thoracoscopy to Diagnose Pleural Effusion. A Systematic Review and Meta-Analysis. Archivos de bronconeumologia.


This meta-analysis compared the diagnostic yield and safety of pleural cryobiopsy and flexible forceps biopsy and evaluated 7 studies involving 356 patients. The diagnostic yield was comparable between the techniques (cryobiopsy: 95% (95% CI 92-97) vs. forceps biopsy: 91% (95% CI 87- 94)). Slight bleeding occurred more often during procedures with flexible forceps (85%, 95%; CI 79-90) than with cryobiopsy (67%, 95% CI 62-72; P< 0.001). Furthermore, cryobiopsy specimens were larger, and fewer artifacts were detected. A pooled analysis of the detection of molecular changes could not be performed. Heterogeneity was moderate to high, but the quality of the studies was acceptable. The authors concluded that “Pleural cryobiopsy is a safe technique with a high yield for etiological diagnosis of pleural effusion, and larger specimens with fewer artifacts are obtained. Molecular determinations should be investigated in more depth.”
 

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Products for this intervention

Close-up of the tip of a flexible cryoprobe with a diameter of 2.4 mm for pulmonary procedures / Nahaufnahme der Spitze einer flexiblen Kryosonde mit 2,4 mm Durchmesser für pulmonologische Eingriffe

No. 20402-411

Flexible cryoprobe single-use, Ø 2.4mm, length 1,150mm

Close-up of the tip of a flexible cryoprobe with a diameter of 1.7 mm for pulmonary procedures / Nahaufnahme der Spitze einer flexiblen Kryosonde mit 1,7 mm Durchmesser für pulmonologische Eingriffe

No. 20402-410

Flexible cryoprobe single-use, ø 1.7mm, length 1150mm

Close-up of the tip of a flexible cryoprobe with a diameter of 1.1 mm for pulmonary procedures / Nahaufnahme der Spitze einer flexiblen Kryosonde mit 1,1 mm Durchmesser für pulmonologische Eingriffe

No. 20402-401

Flexible cryoprobe single-use, ø 1.1mm, length 1150mm, with oversheath, length 817mm, with oversheath ø 2.6mm

Close-up of the tip of a flexible cryoprobe with a diameter of 1.1 mm for pulmonary procedures / Nahaufnahme der Spitze einer flexiblen Kryosonde mit 1,1 mm Durchmesser für pulmonologische Eingriffe

No. 20402-402

Flexible cryoprobe single-use, ø 1.1mm, length 1150mm with oversheath, length 757mm, with oversheath ø 2.6mm No. 20402-402

More PRODUCT Info

 

  • The removal tool with the oversheat in combination with the 1.1mm cryoprobe makes the procedure more convenient