Endobronchial valves in the treatment of persistent air leak, an alternative to surgery

Arch Bronconeumol. 2015 Jan;51(1):10-5. doi: 10.1016/j.arbres.2014.04.007. Epub 2014 Nov 11.
[Article in English, Spanish]

Abstract

Introduction: Persistent air leak is frustrating for both patients and physicians, above all leaks with a high risk of surgery. Insertion of endobronchial valves could be an alternative to surgery. The aim of this study is to describe our experience in these valves and analyse their efficacy in a series of patients with persistent air leaks.

Material and methods: The valves are inserted by means of flexible bronchoscopy under conscious sedation and local anesthesia. A preliminary bronchoscopy identifies the air leak by bronchial occlusion using a balloon catheter. A successful outcome is defined as complete disappearance of the leak following removal of the chest drain, without the need for further surgery.

Results: From November 2010 to December 2013, 8 patients with persistent air leaks were treated with endobronchial valves. The number of valves used ranged from 1 to 4 (median 2), with a median duration of air leak prior to placement of 15.5 days. There were no complications and the resolution of the leak was complete in 6 of 8 patients (75%). The median duration of drainage after insertion of the valves was 13 days and the median time to removal of 52.5 days.

Conclusions: Insertion of endobronchial valves is a safe and effective method for treating persistent air leaks, and a valid alternative to surgery.

Keywords: Alveolar-pleural fistula; Endobronchial valve; Fuga aérea prolongada; Fístula alveolopleural; Neumotórax; Persistent air leak; Pneumothorax; Válvula endobronquial.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia, Local
  • Bronchoscopy*
  • Chest Tubes
  • Conscious Sedation
  • Device Removal
  • Equipment Design
  • Female
  • Humans
  • Lung Diseases / therapy*
  • Male
  • Middle Aged
  • Pleural Diseases / therapy*
  • Pneumothorax / therapy
  • Postoperative Complications / therapy
  • Prospective Studies
  • Prostheses and Implants*
  • Pulmonary Alveoli / pathology
  • Pulmonary Disease, Chronic Obstructive / complications
  • Respiratory Tract Fistula / etiology
  • Respiratory Tract Fistula / therapy*
  • Rupture, Spontaneous
  • Silicosis / complications