Endobronchial valve for treatment of persistent air leak complicating spontaneous pneumothorax

Yu, Wai Cho; Yu, Enyan; Kwok, Hau Chung; She, Hoi Lam; Kwong, Kl; Chan, Yu Hong; Tsang, Yuet Ling; Yeung, Yiu Cheong

doi:10.12809/hkmj176823

Cited by 9 publications

(6 citation statements)

References 28 publications

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“…The median time from chest tube to bronchoscopy was 25 days. The location of the air leak could not be identified in 17 (46%) patients and of the remaining 20, only 8 (40%) were successful in stopping the air leak and allowing the chest drain to be removed [ 44 ]. A retrospective study in the US reported success in 48/60 (80%) patients who received EBVs for PAL in the context of SP or iatrogenic pneumothorax [ 45 ].…”

Section: Overview Of Management Of Secondary Spontaneous Pneumothoraxmentioning

confidence: 99%

Management of the Secondary Spontaneous Pneumothorax: Current Guidance, Controversies, and Recent Advances

Nava

Walker

2022

JCM

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Secondary spontaneous pneumothorax (SSP) is a medical emergency where the lung collapses in the presence of underlying chronic lung disease. It is the commonest cause of spontaneous pneumothorax and results in significant breathlessness, higher morbidity, mortality, and longer hospital admissions than with patients with pneumothoraces and no underlying lung disease. This article explores the current guidance, controversies, and recent advances in the management of this condition.

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Section: Overview Of Management Of Secondary Spontaneous Pneumothoraxmentioning

confidence: 99%

Management of the Secondary Spontaneous Pneumothorax: Current Guidance, Controversies, and Recent Advances

Nava

Walker

2022

JCM

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“…EBV success requires evaluation for fissure completeness and collateral ventilation, quantification of air leak, and precise localization of the leak site; all have shown to have an impact on a successful outcome [10][11][12][13][14]. Failures are common, and the overall success rate was reported to be 22% in spontaneous PTX [15]. Detailed discussion about the patient selection, management and follow-up is a broad topic and beyond the scope of our study.…”

Section: Discussionmentioning

confidence: 98%

Endobronchial valves for persistent air leak all-cause mortality and financial impact: US trend from 2012–2016

Mukhtar

Khalid

Shrestha

et al. 2019

Journal of Community Hospital Internal Medicine Perspectives

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Background: Endobronchial valves (EBV) are considered an innovation in the management of the persistent air leak (PAL). They offer a minimally invasive alternative to the traditional approach of pleurodesis and surgical intervention. We examined trends in mortality, length of stay (LOS), and resources utilization in patients who underwent EBV placement for PAL in the US. Methods: We utilized discharge data from the Nationwide Inpatient Sample (NIS) for five years (2012-2016). We included adults diagnosed with a pneumothorax who underwent EBV insertion at ≥ 3 days from the day of chest tube placement; or following invasive thoracic procedure. We analyzed all-cause mortality, LOS, and resources utilization in the study population. Results: A total of 1,885 cases met our inclusion criteria. Patients were mostly middle-aged, males, whites, and had significant comorbidities. The average LOS was 21.8 ± 20.5 days, the mean time for chest tube placement was 3.8 ± 5.9 days, and the mean time for EBV insertion was 10.5 ± 10.3 days. Pleurodesis was performed before and after EBV placement and in 9% and 6%, respectively. Conclusions: Our study showed that the all-cause mortality rate fluctuated throughout the years at around 10%. Despite EBV being a minimally invasive alternative, its use has not trended up significantly during the study period. EBVs are also being used off-label in the US for spontaneous pneumothorax. This study shall provide more data to the scarce literature about EBV for PAL.

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“…An interesting finding is that a higher comorbidity burden appears to be a risk factor for delayed recovery, regardless of the EBVs implantation status. 59 To reduce the risk of infection, migration and granulation tissue formation, it is now recommended that the valve be removed 4–6 weeks after placement or upon resolution of the air leak. 60 Furthermore, the cost of these valves is a drawback that prevents their widespread use in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Bronchoscopic interventions for bronchopleural fistulas

Jin

2023

Ther Adv Respir Dis

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Bronchopleural fistula is a potentially fatal disease most often caused after pneumonectomy. Concomitant problems such as pulmonary infection and respiratory failure are typically the main contributors to patient mortality because of the improper contact between the bronchial and pleural cavity. Therefore, bronchopleural fistulas need immediate treatment, which requires the accurate location and timely closure of the fistula. Currently, bronchoscopic interventions, because of their flexibility and versatility, are reliable alternative therapies in patients for whom surgical intervention is unsuitable. Possible interventions include bronchoscopic placement of blocking agents, atrial septal defect (ASD)/ventricular septal defect (VSD) occluders, airway stents, endobronchial valves (EBVs) and endobronchial Watanabe spigots (EWSs). Recent developments in mesenchymal stem cells (MSCs) transplantation technology and three-dimensional (3D) printed stents have also contributed to the treatment of bronchopleural fistula, but more research is needed to investigate the long-term benefits. This review focuses on the effectiveness of various bronchoscopic measures for the treatment of bronchopleural fistula and the directions for future development.

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Endobronchial valve for treatment of persistent air leak complicating spontaneous pneumothorax

Cited by 9 publications

References 28 publications

Management of the Secondary Spontaneous Pneumothorax: Current Guidance, Controversies, and Recent Advances

Management of the Secondary Spontaneous Pneumothorax: Current Guidance, Controversies, and Recent Advances

Endobronchial valves for persistent air leak all-cause mortality and financial impact: US trend from 2012–2016

Bronchoscopic interventions for bronchopleural fistulas

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