Abstract
Background:
Pneumothorax is a well known complication of endoscopic lung volume reduction with endobronchial valves (EBV).
Aims and objectives:
To investigate the frequency and impact of pneumothorax in EBV therapy for severe emphysema.
Methods:
103 patients treated with EBV from 2011 -13 were retrospectively analysed for events of pneumothorax. Fissure analysis and bronchoscopic assessment (Chartis) had been used in patient- and target lobe selection to confirm absence of collateral ventilation (CV negative status). Complete occlusion of the target lobe with EBV had been achieved.
Results:
Table 1: Events of pneumothorax in 103 pts treated with EBV
22/23 events needed insertion of a chest drain, 4/23 needed removal of EBV, 5/23 needed thoracoscopy for adhesiolysis and closure of bronchopleural fistula.
Conclusion:
In a CV negative cohort treated with EBV for severe emphysema pneumothorax is considerably more frequent compared to historical data (e.g. US- and EURO-VENT trials; pneumothorax rate 4,2% and 4,5%, respectively; Sciurba et al. NEJM 2010:363:1233-44; Herth et al. ERJ 2012:39:1334-42), and is associated with relevant morbidity. Frequency, however, still remains in an acceptable range. Patients and carers should be aware of the possibility of late events.
- © 2014 ERS