TY - JOUR T1 - Intratumoral injection of tranexamic acid for control of biopsy-induced bleeding: Two years' experience of a new bronchoscopic technique JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P3600 AU - Adil Zamani Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P3600.abstract N2 - Background: Significant bleeding may occur following forceps biopsy or brushing of necrotic or hypervascular tumors in the airways. In some cases, such methods as endobronchial instillation of iced saline lavage and epinephrine may fail to control the bleeding.Objectives: To describe and assess the efficacy of a new bronchoscopic technique using intratumoral injection of tranexamic acid (IIT) for control bleeding during biopsy procedure.Method: IIT was performed in those patients who had endoscopically visible tumoral lesions with continued active bleeding following the first attempt of bronchoscopic sampling (forceps biopsy or endobronchial needle aspiration). Tranexamic acid (TEA) in dose of 250-500 mg was injected through a 22-gauge Wang cytology needle (MW-122) into the lesion. After 2-3 minutes of waiting, multiple forceps biopsy specimens were obtained from the lesion.Results: Between Oct 2009 and Jan 2012, 14 male patients (mean age, 61 yrs; range, 41-80 yrs) underwent bronchoscopic IIT. Two patients with drug-eluting stents were on continuous dual antiplatelet therapy (aspirin plus clopidogrel). Multiple (3 to10; mean, 5.7) and deep biopsy specimens were obtained from the lesions without producing active bleeding. The following histopathologic diagnoses were made: squamous cell carcinoma (n=9), non-small cell lung cancer (n=3), and small cell carcinoma (n=2). There were no side effects observed with TEA.Conclusion: Bronchoscopic IIT is a useful and safe technique for controlling significant bleeding due to forceps biopsy procedure, and might be suggested as a prebiopsy injection for endobronchial necrotic or hypervascular tumors. ER -