The following is a summary of “Aspirin use is safe in patients undergoing transbronchial lung cryobiopsy,” published in the November 2023 issue of Pulmonology by Israeli-Shani et al. 

The safety of aspirin in patients undergoing trans-bronchial lung cryobiopsy (TBLC) has not been specifically studied, despite its established safety in other bronchoscopy procedures such as transbronchial biopsies and endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration. This retrospective cohort study aimed to assess whether aspirin increases the risk of bleeding during or after TBLC.

A total of 172 consecutive patients undergoing TBLC were included in the study, with data collected on demographic characteristics and comorbidities. Bleeding severity was categorized based on the intervention needed to halt bleeding: mild-cold saline injection, moderate-adrenalin/hexakarpon injection, or severe-Intensive Care Unit admission after bronchoscopy.

Among the patients, 51 (29.6%) were on aspirin treatment during TBLC. Overall, there was no significant difference in the incidence of moderate to severe bleeding between the aspirin and control groups (41.2% vs. 33.1%, respectively, p>0.31). Clopidogrel, when taken in conjunction with aspirin, was identified as a risk factor for increased bleeding (Odds ratio = 9.8 (1.1–86), p = 0.013). When taken alone, clopidogrel also showed a trend toward increased bleeding, but the results did not reach significance due to the low number of patients (N = 5, Odds ratio = 2.8 (0.46–17.35), p = 0.245). No significant differences were observed between the groups in terms of post-procedural complications, including pneumothorax, hospitalizations, and mortality.

To the best of our knowledge, this study is the first to examine the bleeding risk of cryobiopsy under aspirin treatment. Based on the findings, it appears safe to perform TBLC under aspirin treatment, except for patients concurrently treated with clopidogrel. However, further research is needed to substantiate this conclusion.

Source: sciencedirect.com/science/article/pii/S2405844023092551