TY - JOUR T1 - Electromagnetic navigation bronchoscopy in the management of peripheral lesions in patients contraindication for transthoracic needle biopsy JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.PA2197 VL - 46 IS - suppl 59 SP - PA2197 AU - Noémie Bruel Tronchon AU - Michèle Cottier AU - Marios Froudarakis AU - Jean Michel Vergnon Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/PA2197.abstract N2 - Electromagnetic Navigation Bronchoscopy (ENB) is a recent technique for the diagnosis of peripheral lung lesions. It is an alternative to TransThoracic Needle Biopsy (TTNB) or surgical resection. TTNB and ENB are less invasive and more safe than surgical resection but TTNB is contraindicated in patients with severe respiratory disease (SRD) or with anatomical difficulties.The aim of the study was to investigate the accuracy of ENB to obtain a safe diagnosis in patients with SRD, never reported so far.We have reviewed all electronic files of ENB performed at our institution from June 2005 to January 2015. Patients' inclusion criteria were contraindication for TTNB because of FEV1<35% using ERS'93 guidelines, or because of emphysema lesions or contralateral pneumonectomy, or a lesion in a prone anatomical site, or severe hypoxemia.From 145 ENB realized in our institution, 50 (32%) were included after fulfilling the above criteria. There were 48 men and 2 women with a mean age of 68±9 years. The mean lesion diameter was 34±13.8 mm. 16(32%) patients had emphysema, 21(42%) had FEV1<35%, 7(14%) had an anatomical contraindication, 3(6%) had single lung and 3(6%) had severe hypoxemia. The diagnostic accuracy of ENB in malignant and benign lesions was 67% (28/42) and 37% (3/8) respectively. Complications observed were bleeding in 1 patient (2%) and vasovagal reaction in another (2%). No case of pneumothorax was observed.ENB is safe and accuracy method for the diagnosis of peripheral lesions in patients contraindicated for TTNB due to SRD or anatomical difficulties. It should be proposed as first line diagnostic approach in this patient population. ER -