Lung volume reduction with endobronchial valves in patients with emphysema

ABSTRACT

Introduction: Bronchoscopic lung volume reduction with endobronchial valves is a recently acknowledged treatment option in patients with severe emphysema and absence of interlobar collateral ventilation. In endobronchial valve treatment, implantation of one-way valves leads to deflation of a hyperinflated lung lobe. Multiple studies showed significant improvements in lung function, exercise capacity, and quality of life in this patient subgroup which often did not have any remaining treatment options.

Areas covered: In this review, efficacy outcomes and adverse events of endobronchial valve treatment are summarized. The importance of selection of the right patients and target lobe is discussed. The role of bodyplethysmography, quantitative CT analysis, and quantification of interlobar collateral ventilation in this selection process are evaluated. Furthermore, this review has a special focus on ongoing trials and future perspectives of this treatment.

Expert opinion: Development of advanced diagnostic imaging methods will result in a better patient and target selection and improved outcomes. Furthermore, optimizing the device and the procedure might be an important focus in future developments to enhance outcomes and reduce adverse events.

KEYWORDS:

• Bronchoscopic lung volume reduction
• interventional pulmonology
• endobronchial valves
• chronic obstructive pulmonary disease
• emphysema
• hyperinflation

Declaration of interest

DJ Slebos is an advisor and clinical investigator for PulmonX (CA, USA), PneumRX/BTG (CA, USA), Nuvaria (MN, USA) and CSA Medical (MA, USA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The authors received a grant from the Dutch Lung Foundation for the SOLVE trial (grant number: 5.1.17.171).