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Risks & Possible Complications

EBUS (Endobronchial Ultrasound)
What the published evidence says about risk

EBUS is one of the lowest-risk procedures Dr. Irshad performs. This page summarizes its risks in plain language, using figures reported in large published studies. This is general information, not your individual risk assessment — Dr. Irshad will review your own risk factors with you directly as part of your consent discussion before the procedure.

Risks & possible complications

  • Overall complication rate — low, roughly 1.4–2.2% across large registries of over 1,000–3,000 patients.
  • Bleeding — most is minor and stops on its own; clinically significant bleeding needing treatment is rare, around 0.2–0.7%.
  • Collapsed lung (pneumothorax) — rare, under 1%.
  • Infection — uncommon, roughly 0.2–4% depending on how closely patients are monitored afterward; serious infection in the chest (mediastinitis) is very rare.
  • Sedation-related breathing problems — uncommon, well under 1%, and closely monitored throughout the procedure.
  • Death — extremely rare, well under 1 in 1,000 procedures in the largest published registries.
  • A “negative” result doesn’t rule out cancer with complete certainty. Roughly 1 in 10 negative EBUS results may still miss disease that is present, which is why your team may still recommend a confirmatory procedure (such as mediastinoscopy) if clinical suspicion remains high.
Your own risk varies. Bleeding risk is higher if you are on blood thinners that could not be safely stopped, and infection risk is higher with certain cyst-like mediastinal masses. Ask Dr. Irshad how these factors apply to you.

References

  1. Eapen GA, Shah AM, Lei X, et al. (AQuIRE Bronchoscopy Registry). Complications, consequences, and practice patterns of endobronchial ultrasound-guided transbronchial needle aspiration. Chest. 2013;143(4):1044–53.
  2. Serra Mitjà P, Gonçalves Dos Santos Carvalho F, Garcia Olivé I, et al. Incidence and Risk Factors for Infectious Complications of EBUS-TBNA: Prospective Multicenter Study. Arch Bronconeumol. 2023;59(2):84–9. PubMed
  3. Adams K, Shah PL, Edmonds L, Lim E. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax. 2009;64(9):757–62. PubMed

Common questions about risk

Is EBUS a safe procedure?
Yes — EBUS is one of the lowest-risk procedures in thoracic surgery, with an overall complication rate of roughly 1.4–2.2% and death occurring in well under 1 in 1,000 procedures.
Can EBUS miss a cancer diagnosis?
A negative EBUS result does not rule out cancer with complete certainty — roughly 1 in 10 negative results may still miss disease that is present, which is why a confirmatory procedure such as mediastinoscopy may still be recommended if clinical suspicion remains high.
What are the main risks of EBUS?
The main risks are minor bleeding (most stops on its own), a rare collapsed lung (under 1%), and uncommon infection (0.2–4%). Clinically significant complications are rare.
This page is general information, not medical advice or a consent form. It does not replace the individualized consent discussion you will have with Dr. Irshad, which accounts for your own health, anatomy, and the specific operation planned. If you are experiencing a medical emergency, call 911 or go to your nearest Emergency Department immediately. Published in compliance with the CPSO Advertising Standards Policy.

Questions about your risk?

Dr. Kashif Irshad — Division of Thoracic Surgery, William Osler Health System, Brampton Civic Hospital. Tel: (905) 458-4520 · Fax: (905) 458-4080 · thoracic@williamoslerhs.ca

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