Christopher R Gilbert1, Roberto F Casal2, Hans J Lee3, David Feller-Kopman3, Bernice Frimpong3, H Erhan Dincer4, Eitan Podgaetz5, Sadia Benzaquen6, Adnan Majid7, Erik Folch7, Jed A Gorden8, Praveen Chenna9, Alex Chen9, Wissam Abouzgheib10, Bareng Aletta Sanny Nonyane11, Lonny B Yarmus3. 1. Division of Pulmonary, Allergy, and Critical Care Medicine, Penn State College of Medicine-Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: christopher.gilbert@swedish.org. 2. Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas. 3. Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland. 4. Division of Pulmonary, Allergy, and Critical Care Medicine, University of Minnesota, Minneapolis, Minnesota. 5. Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota. 6. Interventional Pulmonary, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio. 7. Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 8. Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, Washington. 9. Division of Pulmonary and Critical Care Medicine, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Missouri. 10. Division of Pulmonary and Critical Care Medicine, Interventional Pulmonary, Cooper Medical School of Rowan University, Camden, New Jersey. 11. The Johns Hopkins Bloomberg School of Public Health, Department of Biostatistics, Baltimore, Maryland.
Abstract
BACKGROUND: A persistent air leak represents significant clinical management problems, potentially affecting morbidity, mortality, and health care costs. In 2008, a unidirectional, intrabronchial valve received humanitarian device exemption for use in managing prolonged air leak after pulmonary resection. Since its introduction, numerous reports exist but no large series describe current utilization or outcomes. Our aim was to report current use of intrabronchial valves for air leaks and review outcome data associated with its utilization. METHODS: A multicenter, retrospective review of intrabronchial valve utilization from January 2013 to August 2014 was performed at eight centers. Data regarding demographics, valve utilization, and outcomes were analyzed. RESULTS: We identified 112 patients undergoing evaluation for intrabronchial valve placement, with 67% (75 of 112) undergoing valve implantation. Nearly three quarters of patients underwent valve placement for off-label usage (53 of 75). A total of 195 valves were placed in 75 patients (mean 2.6 per patient; range, 1 to 8) with median time to air leak resolution of 16 days (range, 2 to 156). CONCLUSIONS: We present the largest, multicenter study of patients undergoing evaluation for intrabronchial valve use for air leak management. Our data suggest the majority of intrabronchial valve placements are occurring for off-label indications. Although the use of intrabronchial valves are a minimally invasive intervention for air leak management, the lack of rigorously designed studies demonstrating efficacy remains concerning. Prospective randomized controlled studies remain warranted.
BACKGROUND: A persistent air leak represents significant clinical management problems, potentially affecting morbidity, mortality, and health care costs. In 2008, a unidirectional, intrabronchial valve received humanitarian device exemption for use in managing prolonged air leak after pulmonary resection. Since its introduction, numerous reports exist but no large series describe current utilization or outcomes. Our aim was to report current use of intrabronchial valves for air leaks and review outcome data associated with its utilization. METHODS: A multicenter, retrospective review of intrabronchial valve utilization from January 2013 to August 2014 was performed at eight centers. Data regarding demographics, valve utilization, and outcomes were analyzed. RESULTS: We identified 112 patients undergoing evaluation for intrabronchial valve placement, with 67% (75 of 112) undergoing valve implantation. Nearly three quarters of patients underwent valve placement for off-label usage (53 of 75). A total of 195 valves were placed in 75 patients (mean 2.6 per patient; range, 1 to 8) with median time to air leak resolution of 16 days (range, 2 to 156). CONCLUSIONS: We present the largest, multicenter study of patients undergoing evaluation for intrabronchial valve use for air leak management. Our data suggest the majority of intrabronchial valve placements are occurring for off-label indications. Although the use of intrabronchial valves are a minimally invasive intervention for air leak management, the lack of rigorously designed studies demonstrating efficacy remains concerning. Prospective randomized controlled studies remain warranted.
Authors: Rene S Bermea; Joseph Miller; W Wyatt Wilson; Karen Dugan; Laura Frye; Septimiu Murgu; D Kyle Hogarth Journal: Am J Respir Crit Care Med Date: 2019-11-15 Impact factor: 21.405
Authors: Muhanned Abu-Hijleh; Kim Styrvoky; Vikram Anand; Fernando Woll; Lonny Yarmus; Michael S Machuzak; Daniel A Nader; Timothy W Mullett; D Kyle Hogarth; Jennifer W Toth; Ghazwan Acash; Roberto F Casal; Stephen Hazelrigg; Douglas E Wood Journal: Lung Date: 2019-08-28 Impact factor: 2.584
Authors: Alfonso Fiorelli; Antonio D'Andrilli; Roberto Cascone; Luisa Occhiati; Marco Anile; Daniele Diso; Francesco Cassiano; Camilla Poggi; Mohsen Ibrahim; Giacomo Cusumano; Alberto Terminella; Giuseppe Failla; Alba La Sala; Michela Bezzi; Margherita Innocenti; Elena Torricelli; Federico Venuta; Erino Angelo Rendina; Giovanni Vicidomini; Mario Santini; Claudio Andreetti Journal: J Thorac Dis Date: 2018-11 Impact factor: 2.895