The Safety and Efficacy of a Transbronchial Lung Cryobiopsy Using a 1.7-mm Cryoprobe in Older Adult Patients with Suspected Interstitial Lung Disease: A Single-center, Retrospective, Observational Study.

Abstract

Objective The safety and efficacy of a transbronchial lung cryobiopsy (TBLC) in older adult patients have not yet been fully established. We assessed the safety and clinical utility of TBLC in older adult Japanese patients with suspected interstitial lung disease (ILD). Methods We retrospectively reviewed the medical data of patients who underwent TBLC with a 1.7-mm cryoprobe for suspected ILD at the National Hospital Organization Okayama Medical Center between June 2022 and August 2024. Data on complications, diagnostic yield, and treatment after TBLC were collected and analyzed. Patients The patients were divided into two groups: an older adult group (OA group; age ≥70 years; n=31) and a non-older adult group (NOA group; age <70 years; n=19). Results The median age of the patients in the OA group was 72 years. Pneumothorax occurred only in the NOA group (p=0.017), whereas the frequencies of other complications did not differ significantly. No severe complications were noted. The severity of bleeding did not differ significantly between the groups, regardless of the hemostatic method used (p=0.690). The overall diagnostic yield was 82% (OA group: 84%; NOA group: 79%; p=0.715). Idiopathic pulmonary fibrosis was significantly more common in the OA group than in the NOA group (p=0.035), whereas hypersensitivity pneumonitis was significantly more common in the NOA group than in the OA group (p=0.013). Conclusion TBLC may help diagnose ILD in older adult patients, particularly in those with a preserved respiratory function and no apparent contraindications.