Successful Mediastinal Cryobiopsy Using the Slim UCP190F EBUS Bronchoscope and a 25G Needle: Demonstrating the Efficacy of the Ariza‐Pallares Approach

ABSTRACT Mediastinal cryobiopsy is emerging as a powerful adjunct to traditional EBUS‐TBNA, offering larger, architecturally preserved tissue samples. We describe a case demonstrating successful mediastinal cryobiopsy using the newly developed UCP190F endobronchial ultrasound (EBUS) bronchoscope in a patient with a right upper lobe lesion and mediastinal lymphadenopathy. Owing to the device's narrow 1.7 mm working channel, only 25‐gauge needles (0.4 mm diameter) can be used, raising concerns regarding the feasibility of creating a sufficiently stable access tract for introducing a 1.1 mm cryoprobe for mediastinal cryobiopsy. Using the Ariza‐Pallares four‐step method, a navigable tunnel into station 7 was successfully created, enabling safe cryobiopsy and yielding high‐quality histologic samples. This case demonstrates that mediastinal cryobiopsy can be successfully performed even with very small‐gauge needles and with new‐generation thin convex‐probe scopes, expanding the applicability of cryobiopsy across EBUS platforms.