Selective bronchography (SB) to confirm bronchopleural fistula (BPF) in patients with persistent air leaks

Bronchopleural fistula(BPF)requires different diagnostic methods to know its location, number and size for a correct treatment. The aim of our study is to compare the computed tomography scan(CT)results with the selective bronchograpy(SB)information in BPF.Retrospective study including SB between 03.2014-2.2019. We analysed patients factors, pathology, CT and SB results and final treatment.SB technique requires instilling 10cc of Yodohexol Omnipaque® through a radiopaque catheter Combicath® during fluoroscopy, under deep sedation with propofol. We have included 27 SB performed under suspicion of BPF in patients with persistent air leaks(≥5 days). The characteristics of our sample are in table 1.Mean age 59±12 years. Men:88.9%37% lung cancer,18.5% thoracostomy,7.4% pneumonectomyIn our patients, CT reported BPF in 55.55% of them(n=15), discarding it in 44.45%(n=12);however, SB demonstrated BPF in 81.5% of our patients(n=22). Table 2.Positive SBNegative SBPathologic CT scan 50% 80%Normal CT scan 50% 20%PPV(positive predictive value)=73.3%(95%CI,47-99)NPV(negative predictive value)=8.3%(95%CI,0-28)Also, we have proved with SB that in 50% of the cases there was multiple BPF, findings that de CT only described in two cases. The treatment of BPF was performed with:Zephyr unidirectional endobronchial valves(65%), surgical adhesive Bioglue®(25%)and a combination of both(10%).SB technique could be the new gold standard to confirm and quantify B...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research