High-Frequency Jet Ventilation Safe for Percutaneous Lung Tumor Cryoablation

High-frequency jet ventilation appears to be as safe as spontaneous respiration (SR) for percutaneous lung ablation and could increase procedural efficiency, especially for complex cases.

The study, published in the American Journal of Roentgenology, included consecutive adults who underwent CT-guided percutaneous cryoablation of one or more lung tumors with HFJV or SR (January 1, 2017–May 31, 2023). Fintelmann et al. compared major (grade ≥ 3) Common Terminology Criteria for Adverse Events (CTCAE) within 30 days and HLOS ≥ 2 days. Using generalized estimating equations, the authors then compared procedure, room, and CT guidance acquisition times, CT guidance radiation and total radiation dosage, as well as pneumothorax.

“HFJV appears to be as safe as SR but had longer room times,” clarified corresponding author and 2019 ARRS Scholar Florian J. Fintelmann, MD, from Massachusetts General Hospital in Boston. “HFJV can be used in complex cases without significantly impacting hospital length of stay (HLOS) longer than or equal to 2 days, procedure time, or radiation exposure.”

Ultimately, for 208 cryoablations of 310 lung tumors in 139 patients, HFJV—compared with SR—was more commonly used to treat multiple tumors per session (43% vs. 19%; p =.02) and non-peripheral tumors (48% vs. 24%; p <.001), without significant differences in major adverse event rates, procedure times, or radiation exposure (p > .05).

“The choice of ventilation modality during percutaneous lung ablation should be based on patient characteristics and anticipated procedural requirements, as well as operator preference,” the authors added.