TY - JOUR T1 - Role of bronchoscopy in diagnosis, treatment and follow-up of vascular anomalies: A multidisciplinary approach JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 4650 AU - Paola Serio AU - Valentina Fainardi AU - Roberto Leone AU - Denise Colosimo AU - Luigi Arcieri AU - Bruno Murzi AU - Marco Di Maurizio AU - Laura Grisotto AU - Annibale Biggeri AU - Roberto Baggi AU - Lorenzo Mirabile Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/4650.abstract N2 - Background.Vascular anomalies of aortic arch complex can cause compression of tracheobronchial tree and airway obstruction. While increasing evidence suggests the value of bronchoscopy in the diagnosis and during surgery to guide airway decompression, its role in managing residual symptoms after surgical correction is not well defined.Aim.To assess the role of bronchoscopy in diagnosis, surgical treatment and follow-up of patients with vascular anomalies by multidisciplinar approach.Design.Retrospective review of clinical records of children with endoscopic finding of vascular anomalies who required surgical correction.Results.In 61 patients (34 M) evaluated by bronchoscopy a diagnosis of vascular compression obstructing airway lumen by 70% was made. Computed tomography with angiography (CTA) confirmed the type of vascular anomaly hypothesized in 95% of cases. The degree of agreement was evaluated by Kappa statistic (0.96). They underwent surgical correction under bronchoscopic control at median age of 8.7 months (0.2-184.7). Persistent and significant tracheo or bronchomalacia with residual symptoms required silicone (n 12) or metallic stent (n 5) insertion in 17 patients. All silicone stents were successfully removed; metallic stent were considered permanent. At last endoscopic examination (median follow-up 1.6 yrs, 0-8.1) adequate airway patency was described in 93% (n 57) of patients without residual symptoms.Conclusions.Bronchoscopy can anticipate the specific type of vascular compression showing a very high degree of agreement with CTA, assist the surgeon in airway decompression and provide adequate treatment of patients in follow-up suffering persistent symptoms. ER -