Journal of Bronchology & Interventional Pulmonology最新文献

{"title":"Hemodynamic Effects of Topical Oxymetazoline During Pediatric Flexible Bronchoscopy.","authors":"Alex J Katz, Haley Haskett, Lauren M C Grant, Aoife Corcoran, Antoinette W Daou, Pelton Phinizy, Benjamin B Bruins, Vanessa M Mazandi, Kumaran Senthil, Joseph Piccione, Jelte Kelchtermans","doi":"10.1097/LBR.0000000000001084","DOIUrl":"https://doi.org/10.1097/LBR.0000000000001084","url":null,"abstract":"<p><strong>Background: </strong>Bleeding is a well-recognized complication in flexible bronchoscopy, especially with advanced procedures. Oxymetazoline is a topical vasoconstrictor often used to reduce or treat bleeding in the nares and airways.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on pediatric patients undergoing flexible bronchoscopy from 2015 to 2025. Language processing was used to analyze bronchoscopy-related procedures, and mixed-effects logistic regression models were used to compare blood pressure, heart rate, and rescue medication use in cohorts that were exposed to nasal, endobronchial, and no oxymetazoline.</p><p><strong>Results: </strong>A total of 2874 patients (41% female, mean age: 5.8 y) underwent 3978 bronchoscopies, 66 (2%) of which were exposed to endobronchial oxymetazoline and 1039 (26%) to nasal oxymetazoline. Endobronchial oxymetazoline was associated with higher systolic blood pressure (β=5.73; 95% CI: 2.48-8.98; P=0.00067), diastolic blood pressure (β=3.68; 95% CI: 1.41-5.96; P=0.0016), and lower heart rate (β=-6.91; 95% CI: -10.84 to -3.00; P=0.00054). These effects were more pronounced when bleeding was reported. Endobronchial oxymetazoline was associated with increased bradycardia (OR: 1.92; 95% CI: 1.09-3.40; P=0.024), but not with increased rescue medication use (OR: 0.69; 95% CI: 0.38-1.24; P=0.21).</p><p><strong>Conclusion: </strong>Endobronchial and nasal oxymetazoline use during pediatric flexible bronchoscopy is associated with a mild increase in blood pressure and a decrease in heart rate, although it is well-tolerated and appears to be safe without an increased need for clinical intervention.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Tool to Assess Competency in Bronchoscopic Lung Volume Reduction Via Endobronchial Valve Placement.","authors":"Mostafa A Soliman, Hussain A Raza, Christian Ghattas, Laura Frye, Shalini Mehta, Hiren J Mehta, Raed Alalawi, Irfan B Budhani, Danai Khemasuwan, Fawad Chaudry, A Christine Argento, Ali Musani, Victoria Forth, Nicholas J Pastis, Majid Shafiq","doi":"10.1097/LBR.0000000000001089","DOIUrl":"https://doi.org/10.1097/LBR.0000000000001089","url":null,"abstract":"<p><strong>Rationale: </strong>Bronchoscopic lung volume reduction (BLVR) is an established treatment option for severe emphysema, improving lung function and quality of life. Despite its growing use, there are no standardized, validated tools to assess operator competency in performing BLVR, limiting training and credentialing.</p><p><strong>Objective: </strong>To examine the validity of the VSTAT tools, which were designed to assess competency in cognitive and technical skills necessary for BLVR.</p><p><strong>Methods: </strong>The Zephyr and Spiration VSTAT tools were used to assess 29 operators with varying levels of experience. Participants were categorized as Beginners, Intermediates, and Experts. Performance was evaluated through simulated scenarios. Scores were analyzed for reliability, validity, and correlation with clinical experience.</p><p><strong>Results: </strong>The tools demonstrated strong internal consistency (Cronbach α=0.88 for Zephyr and 0.77 for Spiration). Significant differences in scores were observed across proficiency levels, with experts outperforming beginners. VSTAT scores correlated strongly with procedural experience (Spearman ρ=0.95 for Zephyr, ρ=0.70 for Spiration).</p><p><strong>Conclusion: </strong>The VSTAT tools provide a reliable and valid method for assessing BLVR competency. Their integration into training programs and certification processes could standardize the assessment of operator competency in BLVR.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endobronchial Ultrasound-Guided Fine Needle Biopsy in the Diagnosis of Mediastinal Lymphadenopathy: A Randomized Trial.","authors":"Ajmal Khan, Atul Tiwari, Mansi Gupta, Zia Hashim, Alok Nath, Vinita Agrawal, Ojas Gupta, Anup Kumar","doi":"10.1097/LBR.0000000000001085","DOIUrl":"10.1097/LBR.0000000000001085","url":null,"abstract":"<p><strong>Background: </strong>The comparative sampling efficacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) needles in mediastinal lymphadenopathy remains unclear. Would the fine needle biopsy (FNB), with its Franseen design, provide better results than the fine needle aspiration (FNA) during EBUS-TBNA?</p><p><strong>Methods: </strong>We performed a single-center, investigator-initiated, single-blinded, randomized, parallel-group, superiority trial between August 2022 and July 2023. Consecutive patients were randomly assigned (1:1) to undergo EBUS-TBNA with either 19-gauge (G) FNA or 22-G FNB. The primary endpoint was the diagnostic yield, while the secondary endpoints were specimen adequacy and complication rates.</p><p><strong>Results: </strong>The study included 150 patients with a mean age of 44.5±15.1 years (50.7% female patients). The diagnostic yield of FNB was not significantly different from FNA (94.7% vs. 89.3%; difference, 5.4%; 95% CI: -4.0% to 15.0%; P=0.23). Despite this, FNB had a higher rate of adequate tissue (98.6% vs. 86.7%; difference, 11.9%; 95% CI: 4.0%-22.0%; P<0.001) and larger core tissue (11.52 vs. 9.29 mm; mean difference, 2.23 mm; 95% CI: 1.4-3.1mm; P<0.001) than FNA. FNB showed a significantly higher diagnostic yield for histologic samples (90.7% vs. 76.0%; difference, 14.7%; 95% CI: 3.0-27.0; P=0.016) in post hoc analysis; however, this should be considered a hypothesis-generating finding. All procedures were well tolerated except for minor bleeding.</p><p><strong>Conclusion: </strong>Despite similar diagnostic yields, FNB was more effective than FNA in providing larger, adequate core tissue samples. This improvement in specimen quality may suggest a potential clinical benefit for comprehensive diagnosis and advanced pathologic work-up.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Yield and Molecular Testing Adequacy of Transbronchial Cryoprobe Biopsy Versus Needle Aspiration in Robotic Bronchoscopy.","authors":"Tariq Odeh, Vishwajit Hegde, Maggie Chen, Steven Haworth, Maykol Postigo","doi":"10.1097/LBR.0000000000001088","DOIUrl":"10.1097/LBR.0000000000001088","url":null,"abstract":"<p><strong>Background: </strong>In the AQuIRE trial, most cases (83.6%) did not involve transbronchial needle aspiration (TBNA), often underutilized due to challenges in accessing peripheral pulmonary lesions (PPLs). Advances in robotic bronchoscopy with shape-sensing technology (ssRAB) have mitigated these challenges, but the optimal number of needle and cryoprobe passes for reliable diagnosis remains undefined.</p><p><strong>Methods: </strong>This retrospective study compares the diagnostic yield (DY) of TBNA and transbronchial cryoprobe biopsy (TBCB) and their adequacy for molecular testing in PPLs.</p><p><p>We performed a retrospective analysis of 166 patients who underwent ssRAB with both TBNA and TBCB from May to August 2024. Fisher exact tests and McNemar χ2 tests were used to compare prevalence differences in DY and molecular testing adequacy between discordant cases. Odds ratios (OR) and 95% CIs of associations between the number of passes and diagnostic yield and rates of obtaining adequate samples for molecular testing were obtained using generalized linear mixed models (GLMMs) with a logit link.</p><p><strong>Results: </strong>TBCB demonstrated a higher diagnostic rate than TBNA (89% vs. 80%, OR=2.04, 95% CI=1.06-4.03; P=0.032), as well as better rates of obtaining samples adequate for molecular testing (60% vs. 20%, OR=5.94, 95% CI=2.31-16.38, P<0.001). TBCB provided diagnostic yields in 55% (χ2=9.33, P=0.002) of cases where TBNA failed to provide a diagnosis and was able to obtain adequate samples for molecular testing in 42% (χ2=15.06, P<0.001) of cases where TBNA was unable to.</p><p><strong>Conclusion: </strong>TBCB suggests a higher diagnostic yield and higher cellular adequacy for molecular testing compared with TBNA, underscoring its potential value as a reliable and versatile diagnostic tool in PPLs.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Multiplane Tool in Virtual Lesion Confirmation in Augmented Fluoroscopy-Guided Navigational Bronchoscopy for Peripheral Pulmonary Lesions.","authors":"Erik Büscher, Kaid Darwiche, Marcel Opitz, Jane Winantea, Hanna Zellerhoff, Johannes Wienker, Sebastian Zensen, Halil I Tazeoglu, Luca Salhöfer, Johannes Haubold, Jan Büscher, Anika Hüsing, Christian Taube, Lonny Yarmus, Jeffrey Thiboutot, Faustina Funke","doi":"10.1097/LBR.0000000000001091","DOIUrl":"10.1097/LBR.0000000000001091","url":null,"abstract":"<p><strong>Background: </strong>The demand for minimally invasive diagnostic techniques for peripheral pulmonary lesions (PPL) is rising. Augmented fluoroscopy (AF) provides real-time guidance by overlaying CT-derived virtual targets onto fluoroscopic images, yet its diagnostic value remains poorly defined.</p><p><strong>Methods: </strong>We retrospectively analyzed 226 PPLs targeting procedures performed with navigational bronchoscopy supplemented by AF and R-EBUS between December 2019 and March 2024. TIVL was assessed across 5 standard planes (posteroanterior, 30 degrees toward, 30 degrees away, 30 degrees clockwise, and 30 degrees counterclockwise). Diagnostic yield was defined according to the ATS/ACCP strict criteria. Multivariable logistic regression identified predictors of diagnostic success.</p><p><strong>Results: </strong>Of the 226 analyzed PPLs, 101 (44.7%) showed no R-EBUS signal. In lesions without an R-EBUS signal, diagnostic yield increased from 0% with ≤1 plane to 42% with ≥4 planes. In multivariable analysis, TIVL in 3 planes was associated with a >5-fold higher likelihood of diagnostic success (OR: 5.57; P<0.05), and in ≥4 planes with an almost 14-fold increase (OR: 13.6; P=0.01). Lesions within 16 mm of the point of entry demonstrated stepwise yield improvements up to 89% with ≥4 confirmed planes, while more distant lesions showed no significant benefit. In the ≥3-TIVL-plane subgroup, BMI showed a negative trend toward lower diagnostic yield (OR: 0.92; P=0.059).</p><p><strong>Conclusion: </strong>The number of fluoroscopic planes with confirmed TIVL is a significant determinant of diagnostic yield in AF-guided navigational bronchoscopy, particularly in lesions lacking R-EBUS signals. Multiplane TIVL assessment may enhance diagnostic performance in centers without cone-beam CT or digital tomosynthesis availability.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Practices and Self-Reported Proficiency in the US Interventional Pulmonology Fellowships: A National Cross-Sectional Survey.","authors":"Andres L Mora Carpio, Vruksha U Cabral, Erin DeBiasi","doi":"10.1097/LBR.0000000000001086","DOIUrl":"10.1097/LBR.0000000000001086","url":null,"abstract":"<p><strong>Background: </strong>Interventional pulmonology (IP) has expanded rapidly due to procedural advancements and recent ACGME subspecialty recognition. However, significant heterogeneity persists in training curricula and procedural exposure. This study aims to delineate current trends in the United States IP fellowship education.</p><p><strong>Methods: </strong>We conducted a cross-sectional, multisurvey study between June 2024 and August 2025 involving IP fellows (2024 and 2025 cohorts) and program directors (PDs) across 43 accredited US programs (44% of PDs and 34% to 45% of fellows per administration responded). Electronic surveys assessed demographics, training structure, procedural exposure, and perceived proficiency.</p><p><strong>Results: </strong>Compared with 2013, procedural breadth has increased. Fellows reported the greatest self-rated proficiency gains in complex procedures such as rigid intubation, stent placement, ablative therapies, tracheostomy, and pleuroscopy. Procedural volume to proficiency correlations were nonsignificant for most procedures. Only 43% of programs reported using validated instruments to evaluate procedural competence. At the end of the fellowship, there was a strong fellow-PD concordance on fellow proficiency, where PD rated equal or higher than fellows' self-assessment for most procedures.</p><p><strong>Conclusion: </strong>Despite accreditation, variability remains across IP programs on volume, procedural type, and structure of clinical experience. The findings reveal substantial expansion in procedural scope and training infrastructure, accompanied by persistent heterogeneity in program design and assessment practices. Future efforts should prioritize the development of standardized, validated evaluation frameworks and the establishment of objective benchmarks for procedural competence.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonocclusive Balloon Dilation in Severe Tracheobronchial Stenosis: Preserving Ventilation and Oxygenation Throughout the Procedure.","authors":"Elsie Meneses-Petersen, Maribel Botana-Rial, Raquel Martínez-Tomas, Andrés Briones-Gómez, Enrique Cases-Viedma","doi":"10.1097/LBR.0000000000001092","DOIUrl":"10.1097/LBR.0000000000001092","url":null,"abstract":"<p><strong>Background: </strong>Balloon tracheobronchial dilation is a key technique for managing central airway stenosis. Conventional occlusive balloons interrupt ventilation and oxygenation, limiting the duration and safety of dilation. The objective of this study was to evaluate the clinical outcomes of tracheobronchial stenosis dilation using a nonocclusive balloon and to describe relevant technical aspects of its application.</p><p><strong>Methods: </strong>A retrospective cross‑sectional study was conducted, including all patients with central airway stenosis who underwent dilation with a nonocclusive balloon at a tertiary center. In all cases, stenosis severity was ≥50%, confirmed by endoscopic or tomographic assessment, and associated with compatible symptoms. Demographic characteristics, stenosis features, procedural details, oxygenation parameters, and complications were collected.</p><p><strong>Results: </strong>Sixteen procedures were performed in 11 patients; 6 stenoses (54.5%) were malignant. The trachea was the most frequent location (n=8; 72.7%). The median stenosis severity was 83%. The mean minimum oxygen saturation during the procedure was 96.1%±3.6%, increasing to 98.6%±0.8% at the end of the procedure (P=0.009). Most procedures (n=14; 87.5%) included 3 consecutive dilation cycles. In 2 cases (12.5%), a single prolonged cycle was performed, lasting 300 and 600 seconds, respectively. Airway stents were placed in 6 procedures (38%), all in malignant stenosis. Mild complications occurred in 2 patients (13%), consisting of minor or moderate bleeding, not related to balloon dilation.</p><p><strong>Conclusion: </strong>Nonocclusive balloon dilation provides effective treatment of tracheobronchial stenosis while maintaining ventilation and oxygenation. This technique enables longer, safer dilation cycles by eliminating the need for apnea.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten Years of Intrabronchial Valve Use for Treatment of Persistent Air Leaks.","authors":"Holden Caplan, Harpreet Gill, Tessa Kovats, Ashutosh Sachdeva, Gaurav Ajmani, George Mundanchira, Chenchen Zhang, Van K Holden","doi":"10.1097/LBR.0000000000001093","DOIUrl":"10.1097/LBR.0000000000001093","url":null,"abstract":"<p><strong>Background: </strong>Persistent air leaks (PALs), nonhealing fistulas between the bronchoalveolar and pleural space existing for at least 5 to 7 days, are challenging to manage. With the humanitarian use device exemption from the United States Food and Drug Administration beginning in 2008, intrabronchial valves (IBVs) for use in PALs research exist as a burgeoning knowledge base.</p><p><strong>Methods: </strong>We completed a single-center retrospective cohort review of IBV placement for PAL from 2015 to 2025. Descriptive statistics were used to analyze demographic and outcomes data. Fine-Gray analysis was used to determine the impact of the duration of PAL before IBV placement on the probability of ever resolving air leaks.</p><p><strong>Results: </strong>A total of 66 cases were reviewed. Patient comorbidities included COPD (43.9%), acute respiratory distress syndrome (28.8%), ILD (16.7%), lung cancer (16.7%), and prior lung transplant (3.0%). Overall, PAL resolution was 63.6% with an average time to air leak resolution after IBV placement of 10.8 days (95% CI: 4.8-16.8; n=42). One-year all-cause mortality was 36.4% (24/66). Each additional 10 days with a chest tube in place before IBV placement corresponded to a 10% lower probability of PAL resolution over time (sHR: 0.901; 95% CI: 0.815-0.996; P=0.042). The cumulative incidence of PAL resolution at 30 days was 39.4% (95% CI: 6.2-72.6) in patients with ILD versus 66.3% (95% CI: 52.6-79.9) in patients without ILD.</p><p><strong>Conclusion: </strong>The use of IBVs for the treatment of PALs remains an effective treatment option. The effectiveness of air leak resolution may be influenced by the timing of IBV placement.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Complications Following EUS-B Fine-Needle Aspiration Performed by Interventional Pulmonologists: Incidence, Characteristics, and Prospective Cohort Analysis.","authors":"Matilde Ferreira de Almeida, Luís Vaz Rodrigues, Paulo Matos, Maria Lourdes Barradas, Michele de Santis","doi":"10.1097/LBR.0000000000001081","DOIUrl":"10.1097/LBR.0000000000001081","url":null,"abstract":"<p><strong>Background: </strong>To prospectively evaluate the incidence, severity, and clinical implications of esophageal mucosal injury following esophageal ultrasound using a convex EBUS bronchoscope (EUS-B-FNA).</p><p><strong>Methods: </strong>Prospective single-center cohort of 33 adults (37 procedures) undergoing EUS-B-FNA (February to August 2025) for diagnosis or staging of pulmonary or mediastinal lesions. Postprocedure mucosa was systematically assessed by upper endoscopy or EBUS optics and classified by type, location, and extent. Complications, diagnostic yield, sample adequacy, lesion sizes, and potential risk factors were recorded. Patients were followed for 1 month.</p><p><strong>Results: </strong>Mucosal alterations occurred in 89.2% (33/37) of procedures: punctate lesions (48.6%; median: 1 mm, IQR: 0.5 to 2) and edema (29.7%; median: 1 mm, IQR: 0 to 2); erythema and mild hemorrhage in 5.4% each. No ulceration, perforation, stricture, or intervention was required. Two minor events occurred (self-limited vomiting, submucosal edema). No procedure was interrupted, and no readmissions or severe events occurred during follow-up. Diagnostic yield was 59.5% and sample adequacy 86.5%. Median lesion sizes were 30 mm (IQR: 26.3 to 33.8) for intrapulmonary, 17 mm (IQR: 13 to 20) for lymphadenopathy, and 29 mm (IQR: 23.5 to 34.5) for adrenal lesions. Frequent risk factors included active malignancy (n=18) and diabetes (n=11). Median of 3 needle passes. Most procedures (89.2%) used conscious sedation.</p><p><strong>Conclusion: </strong>This first systematic evaluation of esophageal mucosal changes after EUS-B-FNA shows that minor alterations are common but clinically insignificant. The technique is safe, feasible, and diagnostically valuable when performed by interventional pulmonologists. Larger multicenter studies are needed to optimize risk stratification and procedural protocols.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the Codes: A Comprehensive Guide to Interventional Pulmonology Current Procedural Terminology (CPT) Coding and Billing-Part 1: Compensation and Context of CPT Codes Effecting Interventional Pulmonology.","authors":"Niral M Patel, Neeraj R Desai, George Z Cheng, Ali Musani","doi":"10.1097/LBR.0000000000001079","DOIUrl":"10.1097/LBR.0000000000001079","url":null,"abstract":"<p><p>Interventional pulmonology is a young and growing field; this necessitates an understanding of billing, coding, and documentation rules. Interventional pulmonologists may not appreciate these intricacies. Advocating for resources to benefit patients with administrators, insurance companies, and others requires understanding these principles. This series of 4 articles will review the fundamental and advanced aspects of billing, coding, documentation, and programmatic building of an interventional pulmonology program. Part 1 will review the fundamentals of billing, coding, and reimbursement. Part 2 will review bronchoscopy/endoscopy codes and procedural modifiers. Part 3 will review pleural codes and unlisted codes. Part 4 will combine the previous parts and describe approaches to build, expand, and capture the work involved in a robust interventional pulmonary program. Each part will compliment and support the others with the end goal being to create a broad framework for any IP program to use as a foundation to balance patient care, revenue capture, growth, and a clinical work-life balance. This first part of the series will review some of the foundational principles of billing and coding, which will be built on in the subsequent parts of the series. This includes: health care common procedure coding system, current procedural terminology, ambulatory payment categories, and relative value units, among others. This includes how new codes are created, valued, compensated, and how this effects interventional pulmonologists. Without a thorough understanding of optimal medical billing and coding, interventional pulmonologists are often at a disadvantage. This 4-part series seeks to address and rectify this issue.</p>","PeriodicalId":15268,"journal":{"name":"Journal of Bronchology & Interventional Pulmonology","volume":"33 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}