Treatment of Persistent Pulmonary Air Leaks Using Endobronchial Valves

Travaline, John M.; McKenna, Robert J.; Giacomo, Tiziano De; Venuta, Federico; Hazelrigg, Steven R.; Boomer, Mark; Criner, Gerard J.

doi:10.1378/chest.08-2389

Cited by 205 publications

(165 citation statements)

References 19 publications

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“…Also it is reported in up to 45% of cases who have undergone lung volume reduction surgery due to pulmonary emphysema (5). Persistent air leak may cause a high level of mortality, infectious, cardiopulmonary complications and prolonged hospital stays (3,6). The treatment options are thoracostomy drainage, pleurodesis, surgical decortication, surgical repair, endobronchial valves.…”

Section: Discussionmentioning

confidence: 99%

“…Current treatment options of prolonged air leaks involve prolonged tube thoracostomy drainage, pleurodesis, surgical decortication or surgical repair. In patients who are not candidates for surgical treatment, alternative methods can be used such as endobronchial approaches and radiotherapy (3,4). In this case, an endobronchial valve was inserted by flexible bronchoscopy for persistent air leakage, resulting in a complete resolution and lung reexpansion in patient with COPD.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of persistent air leak with endobronchial valves: a case report

Çetınkaya

Yaşar²,

Acat³

2015

Tuberk Toraks

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142was treated with bullectomy five years ago. He had been admitted to the hospital for three times with a similar presentation; a spontaneous, right basal pneumothorax and was treated with tube thoracostomy. He was conscious, with vital signs of arterial blood pressure 135/80 mmHg, the heart rate 92 beats per minute, respiratory rate 28 per minute and an oxygen saturation of 89% at room air. There were decreased respiratory sounds in all zones on the right lung auscultation. Chest imaging demonstrated a total pneumothorax in the right lung (Figure 1). On thoracic-computed tomography (CT), bullous areas at the apexes of both lungs and a right pneumothorax were observed (Figure 2). Tube thoracostomy was performed. Although he had clinically improved, there was no improvement of the right pneumothorax, therefore surgery was considered. But this was

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of persistent air leak with endobronchial valves: a case report

Çetınkaya

Yaşar²,

Acat³

2015

Tuberk Toraks

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“…1 Endobronchial valve placement remains the only endobronchial intervention available, with documented literature supporting use in air leaks. [2][3][4] Although other interventions such as glue and coiling have been reported, the American College of Chest Physicians' statement on prolonged air leaks in pneumothorax suggest avoidance of these endobronchial interventions. 5 Our multidisciplinary team pursued endobronchial valve placement in this patient with a persistent air leak after recurrent pneumothorax in the setting of an advanced refractory malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…4 Endobronchial valve removal was performed secondary to the known pneumonia risk related to endobronchial valve placement 2,3 in an attempt to minimize potential complications in this immunocompromised patient. However, after evidence of recurrence and plans for hospice referral, destination therapy appeared quite appropriate.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Valve Placement as Destination Therapy for Recurrent Pneumothorax in the Setting of Advanced Malignancy

et al. 2014

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The development of a persistent air leak after pneumothorax can be encountered in patients with underlying structural lung disease. In those with advanced malignancy or other comorbidities, the ability to tolerate general anesthesia and thoracoscopic procedures may limit definitive management. We describe the case of a 68-y-old male with refractory acute myelogenous leukemia presenting with recurrent secondary spontaneous pneumothorax and persistent air leak related to an underlying fungal pneumonia. Endobronchial valve placement allowed for timely chest tube removal and discharge from the hospital, as well as avoidance of a thoracoscopic procedure and pleurodesis.

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“…A balloon tipped catheter is used to provide selective bronchial occlusion to determine the segmental or subsegmental airway that results in the greatest decrease in air leak. The endobronchial valve is then inserted in these airways (98,99). The results of the two largest series on endobronchial valve placement are summarized below, and the overall conclusion is it is a promising mode of therapy particularly for patients with no other therapeutic options.…”

Section: Bronchoscopy and Endobronchial Techniquesmentioning

confidence: 99%