Feasibility and safety of transvascular endosonography: a case series

Endosonography is the preferred technique for diagnosing mediastinal lymphadenopathy and the gold standard for mediastinal staging of lung cancer. The presence of major vessels interposed between the airways/esophagus and the target lesion has long been regarded as a concern for major bleeding. Recent scientific evidence, mostly based on case reports/ series, have demonstrated the feasibility and the safety of traversing major thoracic vessels to sample lymph nodes or lung lesions. However, the vast majority of the reported cases were based on EBUS-TBNA while only one case of transvascular EUS-B-FNA was described. We herein present a case series of six transvascular endosonographies in which three patients underwent EUS-B-FNA without any complication. Our case series confirms the utility and safety of transvascular endosonography and highlights that transvascular EUS-B-FNA is a feasible and safe technique.