Bronchoscopic treatment of complex persistent air leaks with endobronchial one-way valves

Abstract

We reported a case series including 5 patients with persistent air-leaks refractory to standard treatment. All patients were unfit for surgery for the presence of co-morbidities and/or severe respiratory failure due to underlying lung diseases. They were successfully treated with bronchoscopic placement of endobronchial one-way valves. Air-leaks stopped in the first 24 h after the procedure in three patients and 3 and 5 days later, respectively, in the remaining two. No complications were observed and follow-up was uneventful in all patients but one died 25 days after the procedure for systemic sepsis due to peritonis. Patients with important, refractory air leaks having clinical repercussions and unfit for surgery should be early reviewed for bronchoscopic valves treatment.

Bronchoscopic lung volume reduction with endobronchial valves for heterogeneous emphysema: long-term results

“…However, the significant morbidity and mortality related to LVRS have led physicians to explore less invasive procedures especially in high-risk surgical patients. Among these, BLVR with EBV is one of the most reported in literature (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and its clinical benefits in selected patients is supported by five randomized studies, several cases series and meta-analysis (3)(4)(5)(6)(7)(8)(9)(10)(11). However, the most of series reported the short-term results of the EBV procedure (3-8) while the long-term results remained unexplored.…”

Endobronchial Valves for the Treatment of Bronchopleural Fistula and Pneumothorax Caused by Pulmonary Cryptococcosis in an AIDS Patient

“…Furthermore, EBVs can be easily removed when the air leaks are resolved to allow adequate time for tissue healing (11). We summarized the published cases using EBVs for PAL(s) in Table 1 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Only three cases were of patients with AIDS, and our case was the only patient whose SP was secondary to PC.…”

Unidirectional endobronchial valves for management of persistent air-leaks: results of a multicenter study

“…All patients were treated with Zephyr EBV (Zephyr, Pulmonx Corporation-Redwood City, CA, USA). In Europe, CE Mark cleared the use of EBVs for the treatment of emphysematous patients, and for damaged lung resulting in air-leaks (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Thus, no specific approval by Institutional Review Board (IRB) was needed.…”

“…In 2001 an American College of Chest Physicians (ACCP) consensus statement did not recommend bronchoscopy for the treatment of PAL (1,2). However, in the last two decades encouraging results have been reported in small case series (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) and review articles (13,14) by the use of bronchial valves, originally designed for management of emphysema. There are currently 2 commercially available types of bronchial valves; the Zephyr endobronchial valve (EBV) (Zephyr, Pulmonx Corporation-Redwood City, CA, USA) and Spiration intra bronchial valves (IBV) (Olympus Respiratory America-Redmond, WA, USA).…”