Safety of endobronchial ultrasound-guided transbronchial needle aspiration in patients with lung cancer within a year after percutaneous coronary intervention.

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) may be necessary for patients with incidental lung cancer during or after coronary intervention. Although EBUS-TBNA is quite safe, the safety in patients who recently received percutaneous coronary intervention (PCI) has not been demonstrated. The aim of this study was to assess the safety of EBUS-TBNA in patients with lung cancer who underwent PCI within one year.

Methods: We retrospectively reviewed the medical records of 24 patients who underwent EBUS-TBNA within one year after PCI between May 2009 and June 2017. Cardiovascular complications (death, myocardial infarction, arrhythmia, and acute heart failure) were assessed as primary outcomes. Procedural-related complications were assessed as secondary outcomes.

Results: The coronary artery diseases requiring PCI were: myocardial infarction (n = 10), unstable angina (n = 10), stable angina (n = 2), and silent ischemia (n = 2). The median interval between PCI and EBUS-TBNA was 125 days (interquartile range: 66-180). Atrial fibrillation with a rapid ventricular response temporarily occurred in one patient after EBUS-TBNA. No other significant cardiovascular complications were encountered. Fifteen patients were administered an anti-thrombotic agent the day of EBUS-TBNA, while four had ceased taking the agent < 4 days before EBUS-TBNA, however, there was no significant bleeding among those patients.

Conclusion: EBUS-TBNA was safe and did not cause serious adverse events in patients with lung cancer who required tissue confirmation or mediastinal staging within one year after PCI. Incidental lung cancer found during or after a coronary intervention should be actively evaluated by EBUS-TBNA.