112:
through a bronchoscope. During the one-hour procedure, the patient receives anesthesia through an intravenous line. After the procedure, patients usually remain in the hospital for at least four days. During hospitalization, the patient receives a series of chest X-rays to monitor the position of the
99:
Spiration, manufactured by
Spiration, Inc., obtained FDA approval in December, 2018, after a clinical trial (EMPROVE) showed the valve improved pulmonary function scores among trial participants. The Spiration valve subsequently was first used in treatment by Dr. Criner at Temple University Hospital.
90:
In the trial, a total of 190 subjects were randomized across 24 hospital sites into two groups. One group received an endobronchial valve. The other received “standard of care” (SOC) under the current guidelines for hyperinflation due to emphysema. The trial found the endobronchial valve reduced
77:
that allow air to exit these sections but not to re-enter. The valves, in effect, cause damaged lung tissue to deflate, thereby reducing the excessive lung volume (hyperinflation) caused by emphysema. Two endobronchial valves have been approved by the FDA for BLVR: Zephyr and
Spiration.
113:
valves. An outpatient follow-up appointment is scheduled for seven to 10 days after the procedure. Additional imaging tests, such as X-rays, and bronchoscopies may be required weeks, months or years following the initial BLVR procedure.
954:
Sciurba, Frank C.; Ernst, Armin; Herth, Felix J. F.; Strange, Charlie; Criner, Gerard J.; Marquette, Charles H.; Kovitz, Kevin L.; Chiacchierini, Richard P.; Goldin, Jonathan; McLennan, Geoffrey; VENT Study
Research Group (2010-09-23).
1122:
May, Nadine; Niehaus-Gebele, Christa; Reichenberger, Frank; Behr, JĂĽrgen; Gesierich, Wolfgang (February 2020). "Screening for
Bronchoscopic Lung Volume Reduction: Reasons for Not Receiving Interventional Treatment".
871:
Criner, Gerard J.; Sue, Richard; Wright, Shawn; Dransfield, Mark; Rivas-Perez, Hiram; Wiese, Tanya; Sciurba, Frank C.; Shah, Pallav L.; Wahidi, Momen M.; de
Oliveira, Hugo Goulart; Morrissey, Brian (2018-05-22).
434:
Criner, Gerard J.; Sue, Richard; Wright, Shawn; Dransfield, Mark; Rivas-Perez, Hiram; Wiese, Tanya; Sciurba, Frank C.; Shah, Pallav L.; Wahidi, Momen M.; de
Oliveira, Hugo Goulart; Morrissey, Brian (2018-11-01).
86:
Zephyr, manufactured by
Pulmonx Corporation, obtained FDA approval in June, 2018, after a clinical research trial (LIBERATE) led by principal investigator Gerard Criner, MD, of Temple University Hospital.
214:
in 2010. Since that time, nearly 80 additional papers have been published related to the efficacy of BLVR, inclusion criteria, anesthesia management during BLVR, and related topics. Key studies include:
1014:
Kumar, Abhishek; Dy, Rajany; Singh, Kanwaljit; Jeffery Mador, M. (February 2017). "Early Trends in
Bronchoscopic Lung Volume Reduction: A Systematic Review and Meta-analysis of Efficacy Parameters".
514:"The EMPROVE Trial - a Randomized, Controlled Multicenter Clinical Study to Evaluate the Safety and Effectiveness of the Spiration? Valve System for Single Lobe Treatment of Severe Emphysema"
545:
755:
1065:
Wang, Yong; Lai, Tian-Wen; Xu, Feng; Zhou, Jie-Sen; Li, Zhou-Yang; Xu, Xu-Chen; Chen, Hai-Pin; Ying, Song-Min; Li, Wen; Shen, Hua-Hao; Chen, Zhi-Hua (2017-09-29).
405:
1067:"Efficacy and safety of bronchoscopic lung volume reduction therapy in patients with severe emphysema: a meta-analysis of randomized controlled trials"
644:
Fernandez-Bussy, Sebastian; Labarca, Gonzalo; Herth, Felix J. F. (2018). "Bronchoscopic Lung Volume
Reduction in Patients with Severe Emphysema".
38:. BLVR evolved from earlier surgical approaches first developed in the 1950s to reduce lung volume by removing damaged portions of the lungs via
564:"One-Year Follow-Up after Endobronchial Valve Treatment in Patients with Emphysema without Collateral Ventilation Treated in the STELVIO Trial"
1322:
31:
1257:
Klooster, Karin; ten Hacken, Nick H.T.; Hartman, Jorine E.; Kerstjens, Huib A.M.; van
Rikxoort, Eva M.; Slebos, Dirk-Jan (2015-12-10).
930:
513:
494:
178:
Improved exercise tolerance (six-minute walk distance, which improved by nearly 40 meters among patients in the LIBERATE study)
874:"A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE)"
437:"A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE)"
697:"Bronchoscopic lung volume reduction using an endobronchial valve to treat a huge emphysematous bullae: a case report"
525:
811:"Lung volume reduction surgery or bronchoscopic lung volume reduction: is there an algorithm for allocation?"
756:"Bronchoscopic lung volume reduction procedures for moderate to severe chronic obstructive pulmonary disease"
1233:
520:, American Thoracic Society International Conference Abstracts, American Thoracic Society, pp. A7753,
43:
66:
47:
1156:
1047:
912:
677:
475:
619:
512:
Criner, G.j.; Delage, A.; Voelker, K.g.; for the EMPROVE Trial Investigator Group (2018-05-01),
1234:"National Emphysema Treatment Trial (NETT) | National Heart, Lung, and Blood Institute (NHLBI)"
873:
436:
30:. BLVR was initially developed in the early 2000s as a minimally invasive treatment for severe
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Klooster, Karin; Hartman, Jorine E.; ten Hacken, Nick H.T.; Slebos, Dirk-Jan (January 2017).
1280:
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DeCamp, Malcolm M.; McKenna, Robert J.; Deschamps, Claude C.; Krasna, Mark J. (2008-05-01).
280:
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Marruchella, Almerico; Faverio, Paola; Bonaiti, Giulia; Pesci, Alberto (October 2018).
74:
1316:
1160:
39:
916:
681:
479:
1051:
771:
406:"FDA approves novel device for treating breathing difficulty from severe emphysema"
91:
residual lung volume and improved exercise tolerance as compared to the SOC group.
70:
23:
210:
The first clinical research study of BLVR valve implantation was published in the
1136:
892:
754:
Van Agteren, J. E.; Hnin, K.; Grosser, D.; Carson, K. V.; Smith, B. J. (2017).
455:
1259:"Endobronchial Valves for Emphysema without Interlobar Collateral Ventilation"
1082:
1027:
713:
364:
172:
167:
Clinical research has found that BLVR confers measurable benefits, including:
1294:
1201:
1176:"Anaesthesia management for bronchoscopic and surgical lung volume reduction"
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1090:
1035:
992:
983:
900:
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into sections of the lungs damaged by emphysema. Endobronchial valves are
109:
1285:
579:
171:
Improved lung function (reduced residual lung volume, as measured by
58:
BLVR involves the use of valves, coils, or thermal vapour ablation.
957:"A randomized study of endobronchial valves for advanced emphysema"
308:
Sabanathan, S.; Richardson, J.; Pieri-Davies, S. (February 2003).
195:
Pneumothorax (occurred in 26.6% of patients in the LIBERATE trial)
181:
Reduced risk of injury and infection, as compared to pneumonectomy
27:
809:
Gordon, Matthew; Duffy, Sean; Criner, Gerard J. (August 2018).
526:
10.1164/ajrccm-conference.2018.197.1_meetingabstracts.a7753
192:
Exacerbation of COPD (occurs in as many as 14% of patients)
881:
American Journal of Respiratory and Critical Care Medicine
493:
Health, Center for Devices and Radiological (2019-12-20).
444:
American Journal of Respiratory and Critical Care Medicine
201:
Valve expectoration (occurs in as many as 16% of patients)
931:"Bronchoscopic Lung Volume Reduction Benefits and Risks"
646:Seminars in Respiratory and Critical Care Medicine
544:: CS1 maint: DOI inactive as of September 2024 (
620:"Lung volume reduction procedures for emphysema"
198:Pneumonia (occurs in as many as 9% of patients)
1174:Grande, Bastian; Loop, Torsten (August 2018).
108:BLVR valves are placed into the lungs using a
251:"History of lung volume reduction procedures"
8:
695:Lee, Eung Gu; Rhee, Chin Kook (2019-05-14).
353:Proceedings of the American Thoracic Society
760:The Cochrane Database of Systematic Reviews
404:Commissioner, Office of the (2020-02-20).
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184:Reversible, as compared to pneumonectomy
120:
518:C24. NEW TECHNOLOGIES FOR MANAGING COPD
241:
537:
866:
864:
314:The Journal of Cardiovascular Surgery
310:"Bronchoscopic lung volume reduction"
188:BLVR also carries risks, among them:
50:, coils, or thermal vapour ablation.
7:
557:
555:
429:
427:
425:
961:The New England Journal of Medicine
495:"Spiration Valve® System - P180007"
158:Lower risk of injury and infection
17:Bronchoscopic lung volume reduction
14:
46:. Procedures include the use of
1263:New England Journal of Medicine
349:"Lung Volume Reduction Surgery"
212:New England Journal of Medicine
772:10.1002/14651858.CD012158.pub2
1:
22:is a procedure to reduce the
1323:Thoracic surgical procedures
142:Improved exercise tolerance
34:that is primarily caused by
1180:Journal of Thoracic Disease
815:Journal of Thoracic Disease
255:Journal of Thoracic Disease
1339:
1137:10.1007/s00408-019-00303-7
893:10.1164/rccm.201803-0590OC
456:10.1164/rccm.201803-0590OC
1186:(Suppl 23): S2738–S2743.
1083:10.18632/oncotarget.19352
1028:10.1007/s00408-016-9969-x
821:(Suppl 23): S2816–S2823.
714:10.1186/s12890-019-0849-z
365:10.1513/pats.200803-023ET
261:(Suppl 27): S3326–S3334.
828:10.21037/jtd.2018.05.118
268:10.21037/jtd.2018.04.165
1193:10.21037/jtd.2018.02.46
624:British Lung Foundation
134:Improved lung function
701:BMC Pulmonary Medicine
658:10.1055/s-0038-1676774
175:in the LIBERATE study)
1276:10.1056/NEJMoa1507807
974:10.1056/NEJMoa0900928
528:(inactive 2024-09-19)
69:are inserted using a
145:Respiratory failure
67:Endobronchial valves
1077:(44): 78031–78043.
122:
137:COPD exacerbation
121:
117:Benefits and risks
26:of air within the
1269:(24): 2325–2335.
1238:www.nhlbi.nih.gov
984:20.500.12613/6399
967:(13): 1233–1244.
580:10.1159/000453529
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95:Spiration valve
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44:wedge resection
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652:(6): 685–692.
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574:(2): 112–121.
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359:(4): 442–446.
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40:pneumonectomy
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1241:. Retrieved
1237:
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1022:(1): 19–28.
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938:. Retrieved
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628:. Retrieved
626:. 2015-12-07
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82:Zephyr valve
71:bronchoscope
65:
57:
19:
16:
15:
1286:2066/152186
568:Respiration
150:Reversible
1243:2020-03-18
1071:Oncotarget
940:2020-03-18
795:2020-03-18
630:2020-03-18
532:2020-03-18
415:2020-03-18
236:References
161:Pneumonia
54:Procedures
1295:0028-4793
1202:2072-1439
1161:209331149
1145:1432-1750
1091:1949-2553
1036:1432-1750
993:1533-4406
901:1073-449X
837:2072-1439
723:1471-2466
707:(1): 92.
666:1069-3424
588:0025-7931
464:1535-4970
373:1546-3222
326:0021-9509
277:2072-1439
126:Benefits
36:emphysema
1317:Category
1303:26650153
1220:30210826
1153:31832749
1109:29100445
1044:28005150
1001:20860505
917:46894678
909:29787288
855:30210836
790:28230230
741:31088437
682:58559837
674:30641586
606:27974713
540:citation
480:46894678
472:29787288
391:18453353
334:12627080
295:30450238
219:LIBERATE
206:Research
110:catheter
1211:6129807
1100:5652834
1052:1753916
846:6129811
781:6464526
732:6518705
597:5348732
382:2645317
286:6204342
231:STELVIO
222:EMPROVE
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129:Risks
62:Valves
48:valves
24:volume
20:(BLVR)
1157:S2CID
1048:S2CID
913:S2CID
877:(PDF)
678:S2CID
476:S2CID
440:(PDF)
28:lungs
1299:PMID
1291:ISSN
1216:PMID
1198:ISSN
1149:PMID
1141:ISSN
1125:Lung
1105:PMID
1087:ISSN
1040:PMID
1032:ISSN
1016:Lung
997:PMID
989:ISSN
905:PMID
897:ISSN
851:PMID
833:ISSN
786:PMID
764:2017
737:PMID
719:ISSN
670:PMID
662:ISSN
602:PMID
584:ISSN
546:link
468:PMID
460:ISSN
387:PMID
369:ISSN
330:PMID
322:ISSN
291:PMID
273:ISSN
228:VENT
225:NETT
173:FEV1
32:COPD
1281:hdl
1271:doi
1267:373
1206:PMC
1188:doi
1133:doi
1129:198
1095:PMC
1079:doi
1024:doi
1020:195
979:hdl
969:doi
965:363
889:doi
885:198
841:PMC
823:doi
776:PMC
768:doi
727:PMC
709:doi
654:doi
592:PMC
576:doi
522:doi
499:FDA
452:doi
448:198
410:FDA
377:PMC
361:doi
281:PMC
263:doi
42:or
1319::
1297:.
1289:.
1279:.
1265:.
1261:.
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