2014
DOI: 10.1136/thoraxjnl-2014-205127
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Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (The BeLieVeR-HIFi trial): study design and rationale

Abstract: Although lung volume reduction surgery improves survival in selected patients with emphysema, there has been ongoing interest in developing and evaluating bronchoscopic approaches to try to reduce lung volumes with less morbidity and mortality. The placement of endobronchial valves is one such technique, and although some patients have had a significant improvement, responses have been inconsistent because collateral ventilation prevents lobar atelectasis. We describe the protocol of a trial (ISRCTN04761234) a… Show more

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Cited by 55 publications
(43 citation statements)
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“…23,24 Indeed, the BeLiever HiFi RCT, when completed, would help us understand whether an approach treating only the subgroup of patients with intact fissures and the most heterogeneous pattern of emphysema would lead to a better and long-term improvement in FEV 1 and exercise capacity. 25 Our meta-analysis has a few strengths. First, our meta-analysis incorporated all studies that analyzed endobronchial Zephyr valves.…”
Section: Discussionmentioning
confidence: 99%
“…23,24 Indeed, the BeLiever HiFi RCT, when completed, would help us understand whether an approach treating only the subgroup of patients with intact fissures and the most heterogeneous pattern of emphysema would lead to a better and long-term improvement in FEV 1 and exercise capacity. 25 Our meta-analysis has a few strengths. First, our meta-analysis incorporated all studies that analyzed endobronchial Zephyr valves.…”
Section: Discussionmentioning
confidence: 99%
“…For example, the placebo procedure involved laparoscopy but without ablation 36 , endoscopy without radiofrequency energy delivery 37 , bronchoscopy without radiofrequency energy delivery 38 , or bronchoscopy without valve placement 39 . Therefore, most of the studies required a small incision to mimic the portals created during the laparoscopy or arthroscopy, or to mimic the incision through which an intravascular catheter was inserted 40 .…”
Section: Strategies Used To Maintain Blinding In Interventional Placementioning
confidence: 99%
“…A reduction of lung volume can be forecast with an accuracy of approximately 75 % using the Chartis ® evaluation system. However, this method does not replace CT. A prospective study is currently being conducted to determine whether the clinical benefit can be predicted when a homogenous emphysema with intact fissure is diagnosed using CT [60]. Overall, fissure analysis using CT must be viewed cautiously for the time being.…”
Section: Fissure Analysis: the Interlobular Fissuresmentioning
confidence: 99%