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Author Spotlight: Expanding Interventional Pulmonology Research with Robotic-Assisted Bronchoscopy
Published on: July 19, 2024
Novel Combination of a 1.4-mm Radiofrequency Ablation Catheter with Ultrathin Bronchoscope for Subpleural Peripheral
Sze Shyang Kho1, Chan Sin Chai2, Noor Annisa Darman3
1Division of Respiratory Medicine, Department of Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak, Malaysia, khosze@moh.gov.my.
Introduction:
Bronchoscopic ablation is a promising minimally invasive treatment for peripheral lung tumors, avoiding the high complications associated with percutaneous approaches. However, existing ablation catheters are mostly incompatible with ultrathin bronchoscope (UTB), potentially limiting access to subpleural lesions. We report a case of successful bronchoscopic ablation using a novel 1.4-mm radiofrequency (RF) catheter delivered through a UTB.
Case Presentation:
A 53-year-old woman with oligometastatic gastroesophageal adenocarcinoma underwent bronchoscopic ablation for a 12-mm apical right upper lobe metastasis. The UTB was navigated to the 8th airway generation under direct bronchoscopic vision, and the flexible RF catheter was smoothly inserted through the UTB's 1.7-mm working channel. Real-time cone-beam CT confirmed accurate catheter positioning, ensuring safe ablation without pleural puncture. A total of 26 kJ of energy was delivered over 513 s. The patient recovered without complications and was discharged 48 h post-procedure.
Conclusion:
The RF catheter's small diameter and high flexibility allow UTB to remain precise and maneuverable in the peripheral airway. As peripheral bronchoscopy evolves beyond diagnostics, integrating miniaturized therapeutic tools such as the 1.4-mm RF catheter will be crucial in expanding its clinical utility. Further results from ongoing clinical trials are highly anticipated to validate the long-term feasibility and safety of this technique.
