Asymmetric Franseen type needles: a promising alternative for the EUS-guided tissue acquisition for the assessment of gastrointestinal lesions

Aims EUS-FNB tissue sampling is nowadays considered crucial for the management of pancreatic and subepithelial solid lesions (SSLs). According to the recently published data, Franseen symmetric and Fork-tip needles are considered the best-performing ones. In our center, we have newly introduced a new Franseen multiblade asymmetric three-prong tip needle (EUS-FNB Micro-Tech Trident), with a dominant prong designed to facilitate tissue penetration. In this study, we evaluate the diagnostic accuracy and sample adequacy of this new device.

Methods We collected retrospectively all patients who underwent EUS-FNB for pancreatic lesions and SSLs from January to June 2022 with a 22G needle with the slow-pull technique. Diagnostic accuracy was the primary outcome; secondary outcomes were sample adequacy defined by the Macroscopic On-site Evaluation (MOSE) and the number of adverse events. The final diagnosis was determined by surgery or clinical follow-up of at least three months.

Results 46 lesions (of which 70% pancreatic) were sampled with an average size of 30 mm (SD=14mm). Sampling was performed with 2 or 3 passes, according to the macroscopic evaluation. Diagnostic accuracy was 95% (44 confirmed histological diagnosis). Sample adequacy reached approximately 98%; only 2 samples were inconclusive. No major adverse events were detected; 2 patients complained of abdominal discomfort after the procedure.

Conclusions Among the newest generation of EUS-FNB needles, Franseen asymmetric type needles seem to ensure better performances compared with standard Franseen or Fork-tip ones, in terms of diagnostic accuracy and sample adequacy. Due to the limited number of patients additional data are needed.

Publication History

Article published online:
14 April 2023