Safety of Flexible Bronchoscopy, Rigid Bronchoscopy, and Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Patients With Malignant Space-Occupying Brain Lesions

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Abstract

BACKGROUND:

Bronchoscopy in patients with space-occupying brain lesions is anecdotally felt to carry a high risk of neurologic complications.

METHODS:

We conducted a retrospective cohort study of patients with evidence of a malignant, space-occupying brain lesion who were referred for flexible or rigid bronchoscopy or endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The primary outcome of interest was the incidence of neurologic complications following the procedures in these patients.

RESULTS:

Of the 103 enrolled patients, flexible bronchoscopy was performed in 41, rigid bronchoscopy in 12, and EBUS-TBNA in 50. Among these patients, 41 (40%) had evidence suggestive of increased intracranial pressure on imaging. Among all study patients, none (95% CI, 0-0.035) had neurologic, procedure-specific, or sedation-specific complications, and the level of care was not escalated in any of these patients.

CONCLUSIONS:

On the basis of our findings, we recommend that procedures such as flexible or rigid bronchoscopy or EBUS-TBNA in patients with malignant space-occupying brain lesions should be considered reasonably safe as long as neurologic findings are stable.

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