title: Endobronchial valves for bronchopleural fistula: pitfalls and principles.
abstract: Placement of endobronchial valves for bronchopleural fistula (BPF) is not always straightforward. A simple guide to the steps for an uncomplicated procedure does not encompass pitfalls that need to be understood and overcome to maximize the efficacy of this modality.
  
  
  
  The objective of this study was to discuss examples of difficult cases for which the placement of endobronchial valves was not straightforward and required alterations in the usual basic steps. Subsequently, we aimed to provide guiding principles for a successful procedure.
  
  
  
  Six illustrative cases were selected to demonstrate issues that can arise during endobronchial valve placement.
  
  
  
  In each case, a real or apparent lack of decrease in airflow through a BPF was diagnosed and addressed. We have used the selected problem cases to illustrate principles, with the goal of helping to increase the success rate for endobronchial valve placement in the treatment of BPF.
  
  
  
  This series demonstrates issues that complicate effective placement of endobronchial valves for BPF. These issues form the basis for troubleshooting steps that complement the basic procedural steps.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Cooper Medical School at Rowan University, Camden, NJ, USA.
authors.forename: Dany
authors.initials: D
authors.lastname: Gaspard
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Thaddeus
authors.initials: T
authors.lastname: Bartter
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Cooper Medical School at Rowan University, Camden, NJ, USA.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Boujaoude
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Cooper Medical School at Rowan University, Camden, NJ, USA.
authors.forename: Haroon
authors.initials: H
authors.lastname: Raja
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Cooper Medical School at Rowan University, Camden, NJ, USA.
authors.forename: Rohan
authors.initials: R
authors.lastname: Arya
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Meena
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Cooper Medical School at Rowan University, 3 Cooper Plaza, Suite 312, Camden, NJ 08103, USA.
authors.forename: Wissam
authors.initials: W
authors.lastname: Abouzgheib
mesh_terms: D000328:Adult; D000368:Aged; D001983:Bronchial Fistula / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000473:pathology / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome
keywords: bronchopleural fistula; endobronchial valves; prolonged air leak