# Combining biopsy needle and virtual bronchoscopy for tuberculosis‐induced complete bronchial blockage

## TL;DR

A new technique using a biopsy needle and virtual bronchoscopy successfully treated a complete bronchial blockage caused by tuberculosis.

## Contribution

A novel flexible approach combining biopsy needles and virtual bronchoscopy for treating complete bronchial obstruction in tuberculosis.

## Key findings

- A 21-gauge biopsy needle successfully punctured a complete bronchial obstruction under fluoroscopic guidance.
- Virtual bronchoscopy ensured safe navigation around critical vascular structures during the procedure.
- The patient experienced significant symptomatic improvement without complications postoperatively.

## Abstract

Endobronchial tuberculosis (EBTB) presents significant clinical challenges, particularly when complete bronchial obstruction occurs. In this case, a young woman with right main bronchus occlusion due to tuberculosis (TB) was treated using a novel approach. Instead of using a traditional rigid bronchoscope, a flexible approach was adopted. Under precise fluoroscopic guidance, a 21‐gauge transbronchial aspiration needle was used to puncture the obstruction, allowing passage of the guidewire and subsequent balloon dilation. The use of virtual bronchoscopy, developed using computed tomography scans, ensures safe navigation around critical vascular structures. Postoperatively, the patient showed significant symptomatic improvement without complications. This innovative approach not only demonstrates the efficacy and safety of using biopsy needles and virtual bronchoscopy for managing complete bronchial obstructions in EBTB but also opens the door for future innovative solutions in such complex cases.

Our case report details the successful use of a biopsy needle to puncture a completely obstructed bronchus, followed by balloon dilation facilitated by virtual bronchoscopy. This technique, performed under precise fluoroscopic guidance, allowed safe and effective management of the obstruction, leading to significant patient improvement without complications.