Percutaneous lung biopsy in the horse: comparison of two instruments and repeated biopsy in horses with induced acute interstitial pneumopathy.
Authors: Venner M, Schmidbauer S, Drommer W, Deegen E
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Percutaneous Lung Biopsy Instruments in Horses Percutaneous lung biopsy is a valuable diagnostic tool for horses with suspected interstitial lung disease, yet the procedural risks and specimen quality can vary significantly depending on technique and equipment. Venner and colleagues compared the manual Tru-Cut needle (TC) with an automated biopsy needle (ABN) across two experiments: the first involved 50 horses undergoing bilateral biopsies with each instrument, whilst the second evaluated repeated biopsies in six horses over multiple occasions. The ABN demonstrated clear advantages, producing significantly less airway bleeding (5 of 49 horses versus 16 of 49 with TC) and smaller tissue hematomas at necropsy, whilst maintaining good specimen quality; notably, complications including epistaxis and pneumothorax remained uncommon in both groups, though the TC generated larger haematomas and greater bleeding into the airways during repeated sampling. For practitioners performing diagnostic lung biopsies, these findings suggest that adopting automated needle technology can meaningfully reduce tissue trauma and associated complications, particularly when repeated sampling may be necessary to establish a diagnosis—though manual instruments remain viable when automated equipment is unavailable, provided clinicians remain alert to bleeding complications.
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Practical Takeaways
- •When lung biopsy is necessary in horses, the automated biopsy needle should be preferred over manual Tru-Cut needle as it produces less airway bleeding and smaller hematomas at the biopsy site
- •Single lung biopsies carry low risk of serious complications (1% pneumothorax rate) but expect some epistaxis and coughing in 12-20% of cases
- •If repeated lung biopsies are required, clinicians should be prepared for higher complication rates, with bleeding into airways occurring in about 40% of procedures
Key Findings
- •Automated biopsy needle (ABN) induced significantly smaller amount of bleeding into airways (5/49 horses) compared to manual Tru-Cut needle (16/49 horses)
- •Hematoma diameter at biopsy site was significantly larger after Tru-Cut biopsy than ABN in postmortem examination of 7 horses
- •Coughing occurred in 10/50 horses and epistaxis in 6/50 horses with single biopsies; pneumothorax detected in only 1/50 horses
- •In repeated biopsy protocol (104 occasions across 6 horses), pneumothorax occurred in 4/104 occasions and bleeding into airways in 41/104 occasions, with ABN showing fewer complications than Tru-Cut