Optimizing clinical outcomes for bronchoscopic lung volume reduction with Zephyr® valves

T David Koster¹, Pallav L Shah², Arschang Valipour³, Gerard J Criner⁴, Felix J F Herth⁵, Richard Sue⁶, Douglas K Hogarth⁷, Ralitza T Martin⁸, Amit K Mahajan⁹, Raed Alalawi¹⁰, Lisa Kopas¹¹, Avi Cohen¹², Douglas E Wood¹³, Jonathan Kurman¹⁴, Narinder S Shargill¹⁵, Mark Dransfield¹⁶, Dirk-Jan Slebos¹⁷, Michael Perch¹⁸

Affiliations

¹ Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: t.d.koster@umcg.nl.
² Royal Brompton Hospital, Department of Pulmonology, London, United Kingdom; National Heart & Lung Institute, Imperial College, London, United Kingdom.
³ Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Health Care Group, Vienna, Austria.
⁴ Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
⁵ Department of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), University of Heidelberg, Heidelberg, Germany.
⁶ Advanced Lung Institute, Banner University Phoenix, Phoenix, AZ, USA.
⁷ Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, USA.
⁸ Piedmont/MD Anderson Healthcare Network System, Houston, TX, USA.
⁹ Inova Health System, Fairfax, VA, USA.
¹⁰ Banner Health, University of Arizona College of Medicine, Phoenix, AZ, USA.
¹¹ Houston Methodist Hospital, Weill Cornell Medical College, Houston, TX, USA.
¹² Henry Ford Health System, Detroit, MI, USA.
¹³ Department of Surgery, University of Washington, Seattle, WA, USA.
¹⁴ Division of Pulmonary & Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA.
¹⁵ Pulmonx Corporation, Redwood City, CA, USA.
¹⁶ Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁷ Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
¹⁸ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Section for Lung Transplantation and Respiratory Medicine, Herat Center, Rigshospitalet, Copenhagen, Denmark.

PMID: 38642906
DOI: 10.1016/j.rmed.2024.107639

Free article

Review

Optimizing clinical outcomes for bronchoscopic lung volume reduction with Zephyr® valves

T David Koster et al. Respir Med. 2024 Jun.

Free article

. 2024 Jun:227:107639.

doi: 10.1016/j.rmed.2024.107639. Epub 2024 Apr 18.

Authors

Affiliations

¹ Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: t.d.koster@umcg.nl.
² Royal Brompton Hospital, Department of Pulmonology, London, United Kingdom; National Heart & Lung Institute, Imperial College, London, United Kingdom.
³ Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna Health Care Group, Vienna, Austria.
⁴ Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
⁵ Department of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), University of Heidelberg, Heidelberg, Germany.
⁶ Advanced Lung Institute, Banner University Phoenix, Phoenix, AZ, USA.
⁷ Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, USA.
⁸ Piedmont/MD Anderson Healthcare Network System, Houston, TX, USA.
⁹ Inova Health System, Fairfax, VA, USA.
¹⁰ Banner Health, University of Arizona College of Medicine, Phoenix, AZ, USA.
¹¹ Houston Methodist Hospital, Weill Cornell Medical College, Houston, TX, USA.
¹² Henry Ford Health System, Detroit, MI, USA.
¹³ Department of Surgery, University of Washington, Seattle, WA, USA.
¹⁴ Division of Pulmonary & Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA.
¹⁵ Pulmonx Corporation, Redwood City, CA, USA.
¹⁶ Division of Pulmonary, Allergy and Critical Care, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁷ Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
¹⁸ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Section for Lung Transplantation and Respiratory Medicine, Herat Center, Rigshospitalet, Copenhagen, Denmark.

PMID: 38642906
DOI: 10.1016/j.rmed.2024.107639

Abstract

Bronchoscopic lung volume reduction treatment with Zephyr one-way valves is an effective guideline-based treatment option for patients with severe emphysema and hyperinflation. However, in some cases the treatment response is less than anticipated or there might be a loss of initial treatment effect. Reasons for the lack of response can include incorrect assessment of collateral ventilation, improper valve placement, or patient related factors. Loss of initial benefit can be due to granulation tissue formation and subsequent valve dysfunction, or there may be side effects such as excessive coughing or infectious problems. Careful follow-up after treatment with valves is important and evaluation with a CT scan and/or bronchoscopy is helpful if there is no improvement after treatment or loss of initial benefit. This paper aims to describe the most important causes and provide a strategy of how to approach and manage these patients.

Keywords: Bronchoscopic lung volume reduction; Bronchoscopy; COPD; Endobronchial valves; Granulation tissue; Pneumothorax.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest PS declares consulting fees and educational fees. AV declares educational fees. GJC declares grants/contract, consulting fees, educational fees and participation on a DSMB. FJFH declares educational and consulting fees. DKH declares consulting fees and educational fees. AM declares consulting fees and educational fees. AC declares consulting fees and educational fees. MD declares consulting fees and support for attending meetings by GSK. JK declares consulting fees and educational fees. NS is a full-time employee of Pulmonx Corporation and declares stock options. DJS declares grants/contracts, consulting fees, educational fees and support for attending meetings. MP declares grants, consulting fees, educational fees, support for attending meetings and leadership or fiduciary roles. Regarding the consensus opinion meeting: PS, FJFH, RS, DH, RM, AM, RA, LK, AC, JK, DJS, and MP received travel and accommodation support and honoraria from Pulmonx. AV received an honorarium from Pulmonx. DEW, MD, GJC and TDK have no conflict.

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Optimizing clinical outcomes for bronchoscopic lung volume reduction with Zephyr® valves

Affiliations

Optimizing clinical outcomes for bronchoscopic lung volume reduction with Zephyr® valves

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources