Lung Volume Reduction Therapies for Advanced Emphysema

Berger, Robert L.; DeCamp, Malcolm M.; Criner, Gerard J.; Celli, Bartolomé R.

doi:10.1378/chest.09-1822

Cited by 53 publications

(29 citation statements)

References 41 publications

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“…However, despite an estimated 3 million patients with emphysema in the USA, less than 15 LVRS operations are performed monthly [3]. Among the reasons for these numbers could be the unfavorable cost of the treatment and the reports of significant early mortality and morbidity associated with LVRS [2,4].…”

Section: Introductionmentioning

confidence: 99%

Expert Statement: Pneumothorax Associated with Endoscopic Valve Therapy for Emphysema - Potential Mechanisms, Treatment Algorithm, and Case Examples

et al. 2014

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The use of endoscopically placed unidirectional valves for the treatment of emphysema is increasing. With better patient selection, there is also an increased likelihood of complications associated with the procedure, such as postprocedural pneumothorax. There is, however, little evidence of pneumothorax management in patients with severe COPD and emphysema. This report describes an expert recommendation that has been developed to outline pneumothorax management after valve placement to inform physicians and patients of the risk-benefit profile and to assist them in decision making. Skilled and aggressive pneumothorax management is necessary in this patient population, and by following these recommendations traumatic scenarios, prolonged drainage, extended hospitalizations, and/or surgery might be avoided in many cases.

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Section: Introductionmentioning

confidence: 99%

Expert Statement: Pneumothorax Associated with Endoscopic Valve Therapy for Emphysema - Potential Mechanisms, Treatment Algorithm, and Case Examples

et al. 2014

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“…Several non-surgical lung volume reduction techniques have been developed, including unidirectional valves (EBV and intrabronchial valve) deployment, lung volume reduction coils, biologic lung volume reduction, thermal vapor ablation, and airway tract bypass (21, 22). Among them, EBV deployment has the most abundant clinical data showing its feasibility and safety.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Bronchoscopic Lung Volume Reduction by Endobronchial Valves in Patients with Heterogeneous Emphysema: Report on the First Asian Cases

et al. 2014

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Although many patients with severe emphysema have benefited from bronchoscopic lung volume reduction (BLVR) worldwide, experience of BLVR in Asian emphysema patients is scarce. Between July 2012 and March 2013, seven patients with advanced heterogeneous emphysema underwent BLVR in the Asan Medical Center. They had severe dyspnea and poor lung function (Modified Medical Research Council dyspnea scale 3-4; median forced expiratory volume in 1 sec [FEV1], 0.59 L [19.0 % predicted]; median 6-min walk distance [6MWD], 195 m). Endobronchial valves were inserted into the target lobe which was most hyperinflated and least perfused, and had no collateral ventilation with other lobes. Six patients showed clinical improvement after 1 month. Of them, 2 patients improved to dyspnea scale 1 and 4 patients did to scale 2 (P = 0.026). The median FEV1 increased from 0.59 to 0.89 L (51%; P = 0.028) and the median 6MWD increased from 195 to 252 m (29.2%; P = 0.028). Two patients developed a pneumothorax (one requiring drainage) and one patient experienced slight hemoptysis; however, there were no other serious adverse events. BLVR is effective in Asian advanced emphysema patients, with noted clinical improvements in lung function and exercise capacity.Graphical Abstract

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“…15,16 However, valves are also increasingly utilized in patients with persistent air leaks. 17,18 In our institution, placement of intrabronchial valves for persistent air leaks is approved under the institutional review board protocol (HSM#11-00015).…”

Section: Discussionmentioning

confidence: 99%

Intrabronchial Valves for Treatment of Alveolar-Pleural Fistula in a Patient With Pneumocystis jirovecii Pneumonia

Vicencio

Tozzi²,

Thompson³

et al. 2014

Journal of Bronchology &Amp; Interventional Pulmonology

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Alveolo-pleural fistula is a common complication of severe pulmonary infection. Some patients require long-term placement of chest tubes until spontaneous closure of the fistula takes place, whereas others require surgical intervention. We report a case of a patient with alveolo-pleural fistula secondary to Pneumocystis jirovecii pneumonia who was successfully treated with the use of intrabronchial unidirectional valves inserted using flexible bronchoscopy.

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Lung Volume Reduction Therapies for Advanced Emphysema

Cited by 53 publications

References 41 publications

Expert Statement: Pneumothorax Associated with Endoscopic Valve Therapy for Emphysema - Potential Mechanisms, Treatment Algorithm, and Case Examples

Expert Statement: Pneumothorax Associated with Endoscopic Valve Therapy for Emphysema - Potential Mechanisms, Treatment Algorithm, and Case Examples

Efficacy of Bronchoscopic Lung Volume Reduction by Endobronchial Valves in Patients with Heterogeneous Emphysema: Report on the First Asian Cases

Intrabronchial Valves for Treatment of Alveolar-Pleural Fistula in a Patient With Pneumocystis jirovecii Pneumonia

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