Endobronchial balloon tamponade has been used to control life-threatening
hemoptysis. With the classical balloon tamponade technique, the
bleeding airway is occluded by inflating a balloon
catheter, which is passed through the
bronchoscope. We describe a modified technique of endobronchial balloon tamponade with the introduction of the balloon
catheter parallel to the
bronchoscope, which allows keeping the balloon for a longer period and improves suction capacity. We report 3 patients with persistent
hemoptysis who were successfully managed by this modified endobronchial balloon tamponade technique. In the 3 cases, a snare inserted through a
bronchoscope is used to grasp a balloon
catheter, outside the
bronchoscope. After the correct position of the balloon proximal to the
bleeding, the snare is removed and the balloon inflated. The
bronchoscope is then withdrawn and the balloon is left in the airway. The balloon was kept inflated 72 hours in the
bleeding airway in the first 2 cases with complete resolution of the
hemoptysis. In the last case, the balloon was kept inflated 9 hours, until surgery. There are several advantages of this technique. As the balloon
catheter is inserted outside the
bronchoscope, it provides a better view because of the best suction ability, allowing adequate positioning of the balloon during the procedure. Moreover, the inflated balloon
catheter can be left in place for long periods allowing a definitive control of the
bleeding in some cases or a stabilization of the patient until more invasive and definitive solutions as bronchial artery embolization or surgery can be performed.