Bronchial Catheterization Technique

Abstract

A precise and complete study of the state of the bronchial tree may be performed only with true bronchial catheterization, which not only makes possible a guided and selective bronchography, but also permits the use of other exploratory techniques. A variety of other techniques have proven less satisfactory:

• 1. Subglottic installation (either oral or nasal) has been used for a long time because it is simple and rapid. Its major disadvantage is that the physician cannot control the progression of contrast medium beyond the vocal cords. The bronchography is not directed at the area of interest and is often incomplete.

• 2. produces bilateral opacification if the vaporization is performed proximal to the tracheal bifurcation. The contrast medium penetrates underventilated territories only with extreme difficulty when this method is used; in addition, some of the contrast agents used, such as tantalum, involve certain risks. The examination is limited to bronchography and no other associated techniques are possible.

• 3. Puncture of the crico-thyroid membrane is subject to local complications at the point of puncture; access to the trachea and to the bronchi is narrow, limiting the investigations.