Different hydrophilic and hydrophobic polymers are used as lubricious coatings to reduce vascular traumas in minimally invasive percutaneous procedures. Although they are usually very safe, there is still a risk of serious complications in patients undergoing such procedures, mostly derived from the devices' coating detachment and systemic embolization. The lungs are the most common organ involved, followed by the central nervous system. Yet, cutaneous embolization is unusual, and only 19 cases are available in the literature. Most commonly, they present as asymptomatic retiform purpura on the lower legs, which tends to involve spontaneously. Correct clinical diagnosis is not suspected in most cases, being cholesterol emboly or vasculitis the preferred options. Time interval since surgical procedure and appearance of lesions vary widely but they generally start in the first few days. Histopathological identification of the embolus as bluish, amorphous intraluminal material in dermal vessels is diagnostic, but vasculitic signs are not present. We report 2 cases of skin lesions as the main manifestation of polymer embolization after endovascular surgical procedures. In both cases, biopsy allowed identification of embolized foreign material and lesions resolved without specific treatment.

Background: Cryobiopsy has revolutionized mediastinal and lung parenchymal sampling, offering superior diagnostic yields compared to traditional techniques. However, the need for en bloc removal of the bronchoscope and cryoprobe during sample retrieval compromises the procedural safety and efficiency. We introduced a novel in-channel cryobiopsy extraction method that preserves continuous airway visualization and simplifies the procedural workflow. Methods: In this prospective study, we evaluated 30 cases of mediastinal cryobiopsy through the working channel guided by endobronchial ultrasound (C-Cryo-EBUS) and 10 cases of transbronchial cryobiopsy through the working channel (channel-guided transbronchial cryobiopsy (C-TBCB)], using 1.1 and 1.7 mm cryoprobes. After a standardized 3-s freeze, all tissue samples were extracted directly through the bronchoscope’s working channel without removing the scope. The outcomes assessed included procedural feasibility, diagnostic yield, procedure time, complication rate, and sample quality. Results: All cryobiopsies were successfully retrieved through the working channel, achieving a 100% diagnostic yield in both mediastinal and transbronchial settings. No complications or bronchoscopic damage was observed. Mean procedure times were 15.7 ± 6.3 min (C-Cryo-EBUS) and 14.6 ± 5.8 min (C-TBCB). Continuous visualization throughout the procedure enhanced control, minimized airway trauma, and enabled the immediate management of potential bleeding. The extracted specimens maintained excellent architecture and diagnostic adequacy, comparable to those of traditional methods, but with reduced procedural complexity. Conclusion: The in-channel cryoprobe extraction technique is a feasible, reproducible, and safe alternative to conventional cryobiopsy. It maintains endoscopic visualization, reduces procedure time, and preserves diagnostic sample quality. Its implementation may optimize clinical workflows and promote safer and more efficient cryobiopsy practices in interventional pulmonology.