Dr. Muhammad Athar
Pulmonologist
Bon Secours St. Mary’s Hospital
Richmond, VA
Patient Information: 87 y/o, F
Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol
Nodule: RML 33mm
Target Motion: 11.8mm
Biopsy Result: Adenocarcinoma
Instruments Used: Always-On Tip Tracked® 22ga SPiN Flex® Needle, 19ga Needle, Triple Needle Brush, & SPiN Access Catheter®
Conclusion: Surgical Resection
“A difficult trajectory for sampling was of no issue in providing excellent samples to get this patient a diagnosis due to the SPiN Access Catheter® utilized with Always-On Tip Tracked® instruments. The SPiN Access Catheter® is a great tool to utilize for difficult airway bends.”
Patient History
This 87-year-old female was referred to Dr. Athar as a former smoker with a history of Chronic Kidney Disease. After discovering a 33mm lesion in her right middle lobe, a navigated bronchoscopy was decided upon to diagnose this patient.
Planning
Veran’s inspiration/expiration CT protocol was utilized to conduct the planning portion of the procedure. Dr. Athar segmented the 33mm lesion in the RML finding 11.8mm of motion during respiration calculated by the SPiN Planning® software. Upon first observation, the nodule seemed to have a direct bronchus sign leading Dr. Athar to believe sampling in the lesion’s optimal central portion would be of no issue.
Procedure
Dr. Athar began the procedure utilizing the SPiN Drive® software. The target revealed itself to be outside the airway with a bit of a challenging trajectory. Dr. Athar made the quick decision to utilize the SPiN Access Catheter® which allowed for easy navigation and central target sampling due to the 90° curvature of the catheter. He took several samples switching between the 22ga needle and forceps followed by the tip-tracked triple needle brush. The SPiN Access Catheter® even allowed for a trajectory to be lined up for the tip-tracked 19ga needle to make the last tight bend for a histology sample. Final pathology from this 30-minute procedure reported adenocarcinoma from Dr. Athar’s samples made possible by the SPiN Access Catheter® and other Always-On Tip Tracked® instruments. The patient will be referred to a thoracic surgeon for surgical resection.
