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endobronchial valves

Dany Gaspard, Thaddeus Bartter, Ziad Boujaoude, Haroon Raja, Rohan Arya, Nikhil Meena, Wissam Abouzgheib
BACKGROUND: Placement of endobronchial valves for bronchopleural fistula (BPF) is not always straightforward. A simple guide to the steps for an uncomplicated procedure does not encompass pitfalls that need to be understood and overcome to maximize the efficacy of this modality. OBJECTIVES: The objective of this study was to discuss examples of difficult cases for which the placement of endobronchial valves was not straightforward and required alterations in the usual basic steps...
October 14, 2016: Therapeutic Advances in Respiratory Disease
Peter B Terry, Richard J Traystman
Oxygen delivery and carbon dioxide removal being critical to cell survival, mammals have developed collateral vascular and ventilation systems to ensure tissue viability. Collateral ventilation, defined as ventilation of alveoli via pathways that bypass normal airways, is present in humans and many other species. The presence of collateral ventilation can be beneficial in certain disease states, while its relative absence can predispose to other diseases. These well defined anatomical pathways contribute little to ventilation in normal humans, but modulate ventilation perfusion imbalance in a variety of diseases including obstructive diseases such as asthma and emphysema...
October 14, 2016: Annals of the American Thoracic Society
Lorenzo Corbetta, Ariela Tofani, Flavio Montinaro, Lucio Michieletto, Loris Ceron, Chiara Moroni, Pier Giorgio Rogasi
BACKGROUND: The poor treatment outcomes of multidrug-resistant tuberculosis (TB) and the emergence of extensively drug-resistant TB and extremely and totally drug-resistant TB highlight the urgent need for new antituberculous drugs and other adjuvant treatment approaches. OBJECTIVES: We have treated cavitary tuberculosis by the application of endobronchial one-way valves (Zephyr®; Pulmonx Inc., Redwood City, Calif., USA) to induce lobar volume reduction as an adjunct to drug treatment...
October 12, 2016: Respiration; International Review of Thoracic Diseases
Franziska C Trudzinski, Philipp M Lepper, Daniela Leppert, Frank Langer, Christian Lensch, Monika Flaig, Robert Bals, Heinrike Wilkens, Peter Minko, Sebastian Fähndrich
Reducing hyperinflated areas in chronic obstructive pulmonary disease, either surgically or endoscopically, leads to improvement of functional parameters. It is unclear if bilateral treatment with endobronchial valves (EBV) aiming at total lobar occlusion is beneficial. The aim of this study was to assess the results after staged bilateral endoscopic treatment with EBV. This is a retrospective analysis of patients with severe airflow obstruction, who were treated bilaterally with EBV in two stages, aiming at subsequent atelectasis...
October 5, 2016: Respiration; International Review of Thoracic Diseases
Pallav L Shah, Felix J Herth, Wouter H van Geffen, Gaetan Deslee, Dirk-Jan Slebos
Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited effects. Surgical resection of the most destroyed sections of the lung can improve pulmonary function and exercise capacity but its benefit is tempered by significant morbidity. This issue stimulated a search for novel approaches to lung volume reduction...
September 29, 2016: Lancet Respiratory Medicine
Charles Bakhos, Peter Doelken, Stevan Pupovac, Ashar Ata, Tom Fabian
BACKGROUND: Prolonged pulmonary air leaks (PALs) are associated with increased morbidity and extended hospital stay. We sought to investigate the role of bronchoscopic placement of 1-way valves in treating this condition. METHODS: We queried a prospectively maintained database of patients with PAL lasting more than 7 days at a tertiary medical center. Main outcome measures included duration of chest tube placement and hospital stay before and after valve deployment...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Franziska C Trudzinski, Anna J Höink, Daniela Leppert, Sebastian Fähndrich, Heinrike Wilkens, Thomas P Graeter, Frank Langer, Robert Bals, Peter Minko, Philipp M Lepper
BACKGROUND: Patients with a forced expiratory volume in 1 s (FEV1) below 20% of the predicted normal values (pred.) and either homogeneous emphysema or low diffusing capacity for carbon monoxide (DLCO) have a high risk for adverse events including death when undergoing surgical lung volume reduction. OBJECTIVES: We hypothesized that selected patients can benefit from endoscopic lung volume reduction (eLVR) despite a very low FEV1. METHODS: This study is a retrospective analysis of consecutive patients with severe airflow obstruction, an FEV1 ≤20% of pred...
2016: Respiration; International Review of Thoracic Diseases
Arschang Valipour, Dirk-Jan Slebos, Felix Herth, Kaid Darwiche, Manfred Wagner, Joachim H Ficker, Christoph Petermann, Ralf-Harto Hubner, Franz Stanzel, Ralf Eberhardt
RATIONALE: Endobronchial valves (EBV) have been successfully used in patients with severe heterogeneous emphysema to improve lung physiology. Limited available data suggests that EBVs are also effective in homogeneous emphysema. OBJECTIVE: To evaluate the efficacy and safety of EBV in patients with homogeneous emphysema with absence of collateral ventilation assessed by Chartis. METHODS: Prospective, multicenter 1:1 randomized controlled trial of EBV plus standard-of-care (SoC) or (SoC) alone...
August 31, 2016: American Journal of Respiratory and Critical Care Medicine
T David Koster, Eva M van Rikxoort, Ralf-Harto Huebner, Felix Doellinger, Karin Klooster, Jean-Paul Charbonnier, Sri Radhakrishnan, Felix J F Herth, Dirk-Jan Slebos
BACKGROUND: Bronchoscopic lung volume reduction using one-way endobronchial valves (EBVs) has been proven to be effective in patients with severe emphysema. However, the selection of patients without collateral ventilation prior to treatment is critical for procedural success. Collateral ventilation can be assessed directly with the Chartis system or indirectly using computed tomography (CT) fissure analysis. OBJECTIVES: We retrospectively evaluated the diagnostic value of a combination of the quantitative CT interlobar fissure completeness score (FCS) and Chartis in predicting responders to EBV therapy...
2016: Respiration; International Review of Thoracic Diseases
Dirk Skowasch, Andreas Fertl, Björn Schwick, Harald Schäfer, Andreas Hellmann, Felix J F Herth
BACKGROUND: Randomized controlled trials indicate that significant lung volume reduction (ELVR) can be obtained with Zephyr® valves by occluding the target lobe in the absence of collateral ventilation, leading to relevant functional benefits in advanced emphysema patients. OBJECTIVES: To observe the long-term effects of endobronchial valve (EBV) implantation in emphysema patients screened by Chartis assessment in the context of daily pulmonology practice. METHODS: The LIVE Study is a prospective, observational, open-label, single-arm, multicenter trial conducted in Germany...
2016: Respiration; International Review of Thoracic Diseases
Justin Garner, Samuel V Kemp, Tudor P Toma, David M Hansell, Michael I Polkey, Pallav L Shah, Nicolas S Hopkinson
No abstract text is available yet for this article.
August 15, 2016: American Journal of Respiratory and Critical Care Medicine
Mei Ding, Ya-Dong Gao, Li Dai, Xin Li, Jiong Yang
No abstract text is available yet for this article.
September 2016: International Journal of Tuberculosis and Lung Disease
Jorine E Hartman, Karin Klooster, Dirk-Jan Slebos, Nick H T Ten Hacken
RATIONALE: Bronchoscopic lung volume reduction using endobronchial valves is a promising treatment for severe emphysema patients without collateral ventilation. Physical activity is an important contributing factor for the autonomy, morbidity and mortality of these patients. OBJECTIVE: We investigated the impact of endobronchial valve treatment on physical activity in severe emphysema patients. METHODS: Physical activity was measured for 7 days by a triaxial accelerometer at baseline and 6 months follow-up after EBV treatment, and compared with standard medical care in a randomized controlled trial...
August 2016: Respiratory Medicine
Alfonso Fiorelli, Alfonso Reginelli, Mario Santini
No abstract text is available yet for this article.
July 2016: Journal of Bronchology & Interventional Pulmonology
Sergio Baldi, Francesco Coni, Giorgio Limerutti, Massimo Baccega, Enrico Ruffini, Paolo Solidoro
Endoscopic treatment of emphysema is supported by different methods, including valves, coils and sealants. The mechanism is mainly related to volume reduction of targeted area. Endobronchial valves (EBV) appear the most studied method. In a multicentre randomised study, placement of unidirectional endobronchial valves resulted in a statistically significant functional improvement in the treated cohort compared to the control. Adverse events, occurring post procedure, included COPD exacerbations, haemoptysis, pneumothorax and pneumonia...
2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Christian Thomsen, Dorothea Theilig, Dominik Herzog, Alexander Poellinger, Felix Doellinger, Nils Schreiter, Vera Schreiter, Dirk Schürmann, Bettina Temmesfeld-Wollbrueck, Stefan Hippenstiel, Norbert Suttorp, Ralf-Harto Hubner
The exclusion of collateral ventilation (CV) and other factors affect the clinical success of endoscopic lung volume reduction (ELVR). However, despite its benefits, the outcome of ELVR remains difficult to predict. We investigated whether clinical success could be predicted by emphysema distribution assessed by computed tomography scan and baseline perfusion assessed by perfusion scintigraphy. Data from 57 patients with no CV in the target lobe (TL) were retrospectively analyzed after ELVR with valves. Pulmonary function tests (PFT), St George's Respiratory Questionnaire (SGRQ), and 6-minute walk tests (6MWT) were performed on patients at baseline...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Aditya Goud, William Krimsky, Marry Caldwel, Brandon Perry, Pooya Heiraty, Saiyad Sarkar, Daniel P Harley, Stephen Selinger
We present the first reported case of the treatment and management of a giant bulla using percutaneous bullectomy and endobronchial valve placement. A 74-year-old woman with chronic obstructive pulmonary disease and a known large bulla in the left chest presented to the emergency department with acute-onset confusion after a traumatic fall. She was subsequently diagnosed with an intracranial hemorrhage in the distribution of the right basal ganglia. Chest imaging revealed a giant apical bulla occupying 80% of the left hemithorax...
2016: Respiration; International Review of Thoracic Diseases
Izabela Tuleta, Carmen Pizarro, Ernst Molitor, Glen Kristiansen, Georg Nickenig, Dirk Skowasch
BACKGROUND: Endoscopic lung volume reduction by means of endobronchial valve implantation is an established therapy in patients with severe emphysema. However, long-term complications such as chronic obstructive pulmonary disease (COPD) exacerbations are a limitation of this method. OBJECTIVES: As the mechanisms underlying increased rates of COPD exacerbations are unknown, the aim of our study was to determine whether infectious or inflammatory factors may contribute to these events and to investingate the consequent need for valve explantation...
2016: Respiration; International Review of Thoracic Diseases
Masamichi Mineshita, Takeo Inoue, Teruomi Miyazawa
Several non-surgical and minimally invasive bronchoscopic interventions, such as bronchoscopic lung volume reduction (BLVR) techniques, have been developed to treat patients with severe chronic obstructive pulmonary disease (COPD). BLVR has been studied for treatment in severe COPD patients with emphysema. BLVR with one-way endobronchial valves is reported to be effective for patients with a heterogeneous emphysema distribution and without inter-lobar collateral ventilation. For the patients with collateral ventilation, and for the patients with homogeneous emphysema, BLVR with lung volume reduction coil has shown promising results...
May 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Eric D Tenda, Abraham Yakub
AIM: to determine the effectiveness of endobronchial valve placement as treatment of emphysema compared to medical care. METHODS: literature searching regarding comparison of endobronchial valve and medical care as treatment of emphysema on PubMed database. The quality of the literatures found was appraised by using critical appraisal sheet from Center of Evidence-Based Medicine, University of Oxford. RESULTS: two randomized controlled trials (RCT) were obtained from literature searching...
January 2016: Acta Medica Indonesiana
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