Combining biopsy needle and virtual bronchoscopy for tuberculosis-induced complete bronchial blockage.

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.