title: Endobronchial valve treatment for prolonged air leaks of the lung: a case series.
abstract: OBJECTIVE
  An endobronchial valve developed for treatment of severe emphysema has characteristics favorable for bronchoscopic treatment of air leaks. We present the results of a consecutive case series treating complex alveolopleural fistula with valves.
  
  
  METHODS
  Patients with air leaks that persisted after treatment gave consent and compassionate use approval was obtained. Bronchoscopy with balloon occlusion was used to identify the airways to be treated. IBV Valves (Spiration, Redmond, WA) were placed after airway measurement.
  
  
  RESULTS
  During a 15-month period, 8 valve placement procedures were performed in 7 patients and all had improvement in the air leak. The median duration of air leakage was 4 weeks before and 1 day after treatment, with a mean of 4.5 days. Discharge within 2 to 3 days of the procedure occurred in 57% of the patients. A median of 3.5 valves (mode, 2.4) were used, and all valve removals were successful. There were no procedural or valve-related complications.
  
  
  CONCLUSIONS
  Removable endobronchial valves appear to be a safe and effective intervention for prolonged air leaks.
authors.affiliation: Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Colin T
authors.initials: CT
authors.lastname: Gillespie
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Sterman
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Cerfolio
authors.forename: Daniel
authors.initials: D
authors.lastname: Nader
authors.forename: Michael S
authors.initials: MS
authors.lastname: Mulligan
authors.forename: Richard A
authors.initials: RA
authors.lastname: Mularski
authors.forename: Ali I
authors.initials: AI
authors.lastname: Musani
authors.forename: John C
authors.initials: JC
authors.lastname: Kucharczuk
authors.forename: H Xavier
authors.initials: HX
authors.lastname: Gonzalez
authors.forename: Steven C
authors.initials: SC
authors.lastname: Springmeyer
mesh_terms: D000293:Adolescent; D000328:Adult; D001980:Bronchi; D015331:Cohort Studies; D057176:Compassionate Use Trials; D004867:Equipment Design; D006801:Humans; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011650:Pulmonary Alveoli; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013510:Pulmonary Surgical Procedures / Q000295:instrumentation*; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult