Document Detail


A multicenter trial of an intrabronchial valve for treatment of severe emphysema.
MedLine Citation:
PMID:  17198782     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Minimally invasive endoscopic treatment of emphysema could provide palliation with less risk than lung volume reduction surgery and offer therapy to patients currently not considered for lung volume reduction surgery. The Intrabronchial Valve is used to block bronchial airflow in the most emphysematous areas of lung. METHODS: Patients with severe chronic obstructive pulmonary disease and heterogeneous upper lobe-predominant emphysema were eligible. Patients underwent flexible bronchoscopic placement of valves into segmental or subsegmental airways in both upper lobes. Outcomes assessed over a minimum of 6 months of follow-up included the safety, feasibility, tolerance, and success of valve placement; health-related quality of life; exercise capacity; pulmonary function; and gas exchange. RESULTS: Five centers treated 30 patients. Patient follow-up ranged from 1 to 12 months. A mean of 6.1 valves were placed per patient. Valves were positioned by means of flexible bronchoscopy in 99% of desired airways, and the procedure duration ranged from 15 to 125 minutes (mean, 65 minutes). Hospital discharge occurred within 2 days in 27 of 30 patients. There were no deaths or episodes of valve migration, tissue erosion, or significant bleeding. Eighty-three percent of patients had no adverse events judged probably or definitely related to the device. Patients experienced significant improvement in health-related quality of life, although the physiologic and exercise outcomes did not show statistically significant improvements. CONCLUSIONS: These first multicenter results with the Intrabronchial Valve demonstrate significant improvements in health-related quality of life and acceptable safety, ease of use, and procedural complication rates. The valve might be a safer and less-invasive alternative to surgical therapy for patients with severe emphysema.
Authors:
Douglas E Wood; Robert J McKenna; Roger D Yusen; Daniel H Sterman; David E Ost; Steven C Springmeyer; H Xavier Gonzalez; Michael S Mulligan; Thomas Gildea; Ward V Houck; Michael Machuzak; Atul C Mehta
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-12-01
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  133     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-02     Completed Date:  2007-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  65-73     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, the University of Washington, Seattle, Wash 98195-6310, USA. dewood@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bronchi*
Bronchoscopy
Exercise Tolerance
Female
Forced Expiratory Volume
Humans
Lung Volume Measurements
Male
Middle Aged
Palliative Care
Prostheses and Implants* / adverse effects
Pulmonary Disease, Chronic Obstructive / physiopathology,  therapy
Pulmonary Emphysema / physiopathology,  therapy*
Pulmonary Gas Exchange
Quality of Life

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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