Bronchoscopic Lung Volume Reduction Using Endobronchial Valves: How to Do It

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. Over the last decade, many studies have validated the use of endobronchial valves (EBVs) for bronchoscopic lung volume reduction (BLVR) in patients who are persistently symptomatic despite optimal medical therapy. We aimed to review the literature and describe appropriate patient selection and procedural considerations. BLVR using EBVs leads to an improvement in FEV1, 6-min walk distance, and health-related quality of life. Two valve systems have recently obtained FDA approval for use for this indication. Appropriate selection of the target lobe and assessment of fissure integrity using quantitative imaging software are essential to obtain best possible outcomes. EBVs are a viable treatment option, with manageable complications, for patients with COPD who have hyperinflation and refractory symptoms, when there is complete fissure integrity (no collateral ventilation).