Bronchography with a directable double catheter.

Abstract

A selective bronchographic technic is mostly exercised in cases where a nonselective approach fails, where selective sampling is required, or where a selective installation of medication is needed. For this purpose a directable double catheter has been used. The external catheter, with a length of 45 cm and an outer diameter of 4 mm, is made of radiopaque polyethylene. Its distal part is slightly curved, and the tip is rounded. The detachable internal catheters are made from the same material. Their length is 55 cm, their outer diameter 2 mm. The tips are soft and flexible. Their various shapes apply to the requirements of the catheterization of upper lobes, lingula, middle lobe, and both lower lobes respectively. All catheters are disposable and are provided with Luer connectors. An internal catheter of chosen shape is introduced into the external tube so that most of its distal curved portion reaches beyond the tip of the outer tube. By simple pushing, pulling, and twisting the inner catheter's distal portion is straightened, recurved, and turned, permitting its maneuvering into the desired bronchus. Within a few seconds the internal catheter can be exchanged and replaced by a more suitable one, if desired. The double catheter is introduced transnasally after local anesthesia of the upper respiratory tract. The outlining of the bronchi is obtained by the aspiration technic, completed with a selective approach. Following selective catheterization of the incompletely filled or otherwise suspected bronchi, sampling by aspiration can be performed, using a vacuum pump. Medication can be administered selectively. However rarely it may occur, laryngo-spasm is a potential danger. In that event the internal catheter is promptly removed, and oxygen is administered through the external catheter. Summary A directable double polyethylene catheter for selective bronchography is described. The method meets requiremements of: 1. Comfortable introduction of the catheters and easy selective catheterization of segmental and subsegmental bronchi 2. The possibility of direct installation of medication 3. Sampling of secretion and selective removal of the contrast material by aspiration 4. Efficient intubation in cases of laryngospasm.