Cadaveric evaluation of bronchial blockade using the Coda vascular catheter placed under Borescope guidance

Objective: To evaluate the feasibility of achieving bronchial blockade using a vascular balloon catheter under low-cost semi-flexible borescope guidance in dogs. Study design: Cadaveric pilot study. Sample population: Canine cadavers (n = 7) weighing between 12.2 and 63 kg. Methods: Two participants attempted four different techniques to achieve bronchus blockade using a 10 Fr Coda catheter or an EZ-blocker (EZ) under borescopic (B) or endoscopic (E) guidance. Placement success was confirmed via thoracoscopy. Success rate, procedure duration, and reasons of failure were recorded. Results: B-Coda catheter placement was possible on dogs intubated with a minimum 8.5 mm size endotracheal tube (ETT). E-EZ was unsuccessful with an 8.5 ETT and below and on some dogs bigger than 30 kg. Excluding the failures due to size limitations of the devices, success rate during first attempt for the left side was 50% for B-EZ and 75% for all other techniques. Right-sided success was 50% for B-EZ, 33% for B-Coda, 66% for E-EZ and 62% for E-Coda. Malpositioning of the devices occurred twice as commonly under borescopic guidance. The techniques were all successful after up to two additional attempts. Time to achieve blockade was faster using endoscopic guidance. Conclusion: The catheter allowed bronchial occlusion in larger canine cadavers. The borescope allowed guidance without the size limitation of the endoscope. Clinical relevance: The Coda catheter had no size limitation in comparison to the EZ blocker and could be analternative to it. A sterilized borescope may be an option when bronchoscope size is inappropriate for a patient.