title: Endobronchial valves in the treatment of persistent air leak, an alternative to surgery.
abstract: BACKGROUND
  Persistent air leak is frustrating for both patients and physicians, above all leaks with a high risk of surgery. Insertion of endobronchial valves could be an alternative to surgery. The aim of this study is to describe our experience in these valves and analyse their efficacy in a series of patients with persistent air leaks.
  
  
  METHODS
  The valves are inserted by means of flexible bronchoscopy under conscious sedation and local anesthesia. A preliminary bronchoscopy identifies the air leak by bronchial occlusion using a balloon catheter. A successful outcome is defined as complete disappearance of the leak following removal of the chest drain, without the need for further surgery.
  
  
  RESULTS
  From November 2010 to December 2013, 8 patients with persistent air leaks were treated with endobronchial valves. The number of valves used ranged from 1 to 4 (median 2), with a median duration of air leak prior to placement of 15.5 days. There were no complications and the resolution of the leak was complete in 6 of 8 patients (75%). The median duration of drainage after insertion of the valves was 13 days and the median time to removal of 52.5 days.
  
  
  CONCLUSIONS
  Insertion of endobronchial valves is a safe and effective method for treating persistent air leaks, and a valid alternative to surgery.
authors.affiliation: Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España. Electronic address: rcordovilla@usal.es.
authors.forename: Rosa
authors.initials: R
authors.lastname: Cordovilla
authors.affiliation: Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: Aldo Mateo
authors.initials: AM
authors.lastname: Torracchi
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Novoa
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Jiménez
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Aranda
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Varela
authors.affiliation: Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Barrueco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D001999:Bronchoscopy; D015505:Chest Tubes; D016292:Procedural Sedation; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000628:therapy*; D011030:Pneumothorax / Q000628:therapy; D011183:Postoperative Complications / Q000628:therapy; D011446:Prospective Studies; D019736:Prostheses and Implants; D011650:Pulmonary Alveoli / Q000473:pathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000628:therapy*; D012422:Rupture, Spontaneous; D012829:Silicosis / Q000150:complications
keywords: Alveolar-pleural fistula; Endobronchial valve; Fuga aérea prolongada; Fístula alveolopleural; Neumotórax; Persistent air leak; Pneumothorax; Válvula endobronquial