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SPiN Perc™ Key in Diagnosing Nodule with No Airway Access

BIOPSY OF LLL LESION
Author
Dr. Cedric Rutland

Pulmonologist

Riverside Community Hospital

Riverside, CA

Patient Information: 67 y/o, F

Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol

Nodule: LLL 29mm

Biopsy Result: Malignant

Instruments Used: Always-On Tip Tracked® Serrated Forceps, 22ga SPiN Flex™ Needle & SPiN Perc™ Kit

Conclusion: Small-cell lung cancer; Radiation treatment

Observations

“I had no direct airway to access the lesion from an endobronchial standpoint, so we converted to SPiN Perc™ and were able to take biopsies of diagnostic tissue. I was able to complete two procedures without having to wake the patient. This demonstrates the great utility of the Veran system.”

Patient History
This 60 year old patient presented to Dr. Rutland in clinic with a nodule in the left lower lobe. Given the patient’s history of smoking, Dr. Rutland decided to pursue a diagnostic procedure using the Veran SPiN Thoracic Navigation System™.

Planning
Upon reviewing the CT scan, Dr. Rutland noted there did not appear to be an airway leading to the nodule. As he was determined to use all available modalities to obtain a diagnosis in this procedure, he then planned a percutaneous approach for SPiN Perc™. This path would access the nodule from the posterior approach through the chest wall.

Procedure
A Navigated Bronchoscopy was performed first using SPiN Drive to attempt to biopsy the LLL lesion using the 22ga SPiN Flex™ needle. The bronchoscopy confirmed Dr. Rutland’s suspicions that there was no way to access the nodule via any of the patient’s airways. The procedure transitioned to SPiN Perc™, where Dr. Rutland proceeded to take several biopsies of the lesion percutaneously. ROSE confirmed diagnostic tissue in the procedure, and followed up with a confirmed diagnosis of small cell lung cancer. By utilizing SPiN Perc™, Dr. Rutland did not have to refer the patient for a second procedure to obtain a diagnosis.

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