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Kristiansen J, Perch M, Iversen M, Krakauer M, Mortensen J. Lobar Quantification by Ventilation/Perfusion SPECT/CT in Patients with Severe Emphysema Undergoing Lung Volume Reduction with Endobronchial Valves. Respiration 2019; 98:230-238. [DOI: 10.1159/000500407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 04/15/2019] [Indexed: 11/19/2022] Open
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Qi F, Tian Q, Chen L, Li C, Zhang S, Liu X, Xiao B. Use of endobronchial valve insertion to treat relapsing pneumothorax: a case report and literature review. CLINICAL RESPIRATORY JOURNAL 2015; 11:411-418. [PMID: 26259915 DOI: 10.1111/crj.12355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 06/24/2015] [Accepted: 08/03/2015] [Indexed: 11/28/2022]
Abstract
Backgorund and Aims: Unidirectional endobronchial valves have recently been shown to be beneficial as treatment for persistent air leaks. This report presents a first case of endobronchial valve implantation to treat relapsing pneumothorax in a Chinese patient, and also presents a review of the literature on the use of one-way valve insertion for the treatment of persistent air leaks. METHODS The patient did undergo a recent but failed chest tube intervention. By bronchoscopy and using Chartis® system measurements, the upper left lobe (including the left apical bronchus) was closed using a catheter. RESULTS After the expected decrease in airflow following bronchial occlusion, increased air pressure and decreased spilled air were noted; it was concluded that the pneumothorax was located in the left upper lobe. A Zephyr® endobronchial valve was placed in the left upper apical bronchus. The health benefits of the procedure were noticed in the following days. CONCLUSION Our review suggests that the use of endobronchial valves could be used as an effective, minimally invasive, low-risk intervention for patients with pneumothorax that cannot be treated surgically.
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Affiliation(s)
- Fei Qi
- Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
| | - Qing Tian
- Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
| | - Liang'an Chen
- Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
| | - Chunyan Li
- Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
| | - Shu Zhang
- Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
| | - Xingchen Liu
- Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
| | - Binbin Xiao
- Department of Respiratory Medicine, Chinese PLA General Hospital, Beijing, China
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Gupta D, Agarwal R, Aggarwal AN, Maturu VN, Dhooria S, Prasad KT, Sehgal IS, Yenge LB, Jindal A, Singh N, Ghoshal AG, Khilnani GC, Samaria JK, Gaur SN, Behera D. Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations. Lung India 2013; 30:228-67. [PMID: 24049265 PMCID: PMC3775210 DOI: 10.4103/0970-2113.116248] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a major public health problem in India. Although several International guidelines for diagnosis and management of COPD are available, yet there are lot of gaps in recognition and management of COPD in India due to vast differences in availability and affordability of healthcare facilities across the country. The Indian Chest Society (ICS) and the National College of Chest Physicians (NCCP) of India have joined hands to come out with these evidence-based guidelines to help the physicians at all levels of healthcare to diagnose and manage COPD in a scientific manner. Besides the International literature, the Indian studies were specifically analyzed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (a) definitions, epidemiology, and disease burden; (b) disease assessment and diagnosis; (c) pharmacologic management of stable COPD; (d) management of acute exacerbations; and (e) nonpharmacologic and preventive measures. The modified grade system was used for classifying the quality of evidence as 1, 2, 3, or usual practice point (UPP). The strength of recommendation was graded as A or B depending upon the level of evidence.
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Affiliation(s)
- Dheeraj Gupta
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashutosh Nath Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V. N. Maturu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K. T. Prasad
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Inderpaul S. Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lakshmikant B. Yenge
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditya Jindal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Navneet Singh
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A. G. Ghoshal
- Department of Pulmonary Medicine, Indian Chest Society, India
| | - G. C. Khilnani
- Department of Pulmonary Medicine, National College of Chest Physicians, India
| | - J. K. Samaria
- Department of Pulmonary Medicine, Indian Chest Society, India
| | - S. N. Gaur
- Department of Pulmonary Medicine, National College of Chest Physicians, India
| | - D. Behera
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Delage A, Marquette CH. Bronchoscopic treatments for emphysema. Rev Mal Respir 2011; 28:e108-14. [DOI: 10.1016/j.rmr.2009.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Accepted: 09/07/2009] [Indexed: 11/27/2022]
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Abstract
Chronic obstructive pulmonary disease is a preventable and treatable disease characterized by progressive and debilitating limitations of airflow. Despite aggressive medical therapy, many patients with advanced emphysema continue to decline and exhibit disabling symptoms. Lung volume reduction surgery and lung transplantation can offer improved quality of life, enhanced exercise tolerance, and improvement in mortality rates in selected patients with advanced disease. In addition, newer bronchoscopic techniques to reduce lung volume in patients with emphysema are under development in an effort to duplicate the results of lung volume reduction surgery without significant morbidity. This article discusses the results of a variety of surgical and bronchoscopic interventions, with an emphasis upon the role of imaging.
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Density-based MDCT quantification of lobar lung volumes: a study of inter- and intraobserver reproducibility. Radiol Med 2010; 115:516-25. [DOI: 10.1007/s11547-010-0536-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 05/07/2009] [Indexed: 11/30/2022]
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La distension doit-elle devenir la préoccupation principale de la prise en charge de la BPCO ? Rev Mal Respir 2008; 25:1219-22. [DOI: 10.1016/s0761-8425(08)75086-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
Lung volume reduction surgery (LVRS) produces physiological, symptomatic, and survival benefits in selected patients with advanced emphysema. Because it is associated with significant morbidity, mortality, and cost, nonsurgical alternatives for achieving volume reduction have been developed. Three bronchoscopic lung volume reduction (BLVR) approaches have shown promise and reached later-stage clinical trials. These include the following: (1) placement of endobronchial one-way valves designed to promote atelectasis by blocking inspiratory flow; (2) formation of airway bypass tracts using a radiofrequency catheter designed to facilitate emptying of damaged lung regions with long expiratory times; and (3) instillation of biological adhesives designed to collapse and remodel hyperinflated lung. The limited clinical data currently available suggest that all three techniques are reasonably safe. However, efficacy signals have been substantially smaller and less durable than those observed after LVRS. Studies to optimize patient selection, refine treatment strategies, characterize procedural safety, elucidate mechanisms of action, and characterize short- and longer-term effectiveness of these approaches are ongoing. Results will be available over the next few years and will determine whether BLVR represents a safe and effective alternative to LVRS.
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Automated lobar quantification of emphysema in patients with severe COPD. Eur Radiol 2008; 18:2723-30. [DOI: 10.1007/s00330-008-1065-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Revised: 05/07/2008] [Accepted: 05/17/2008] [Indexed: 10/21/2022]
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Synthèse : Valves endobronchiques dans la prise en charge thérapeutique de l’emphysème sévère. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)74847-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Strange C, Herth FJF, Kovitz KL, McLennan G, Ernst A, Goldin J, Noppen M, Criner GJ, Sciurba FC. Design of the Endobronchial Valve for Emphysema Palliation Trial (VENT): a non-surgical method of lung volume reduction. BMC Pulm Med 2007; 7:10. [PMID: 17711594 PMCID: PMC1949836 DOI: 10.1186/1471-2466-7-10] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 07/03/2007] [Indexed: 12/04/2022] Open
Abstract
Background Lung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently, less invasive bronchoscopic approaches have been designed to utilize these principles while avoiding the associated perioperative risks. The Endobronchial Valve for Emphysema PalliatioN Trial (VENT) posits that occlusion of a single pulmonary lobe through bronchoscopically placed Zephyr® endobronchial valves will effect significant improvements in lung function and exercise tolerance with an acceptable risk profile in advanced emphysema. Methods The trial design posted on Clinical trials.gov, on August 10, 2005 proposed an enrollment of 270 subjects. Inclusion criteria included: diagnosis of emphysema with forced expiratory volume in one second (FEV1) < 45% of predicted, hyperinflation (total lung capacity measured by body plethysmography > 100%; residual volume > 150% predicted), and heterogeneous emphysema defined using a quantitative chest computed tomography algorithm. Following standardized pulmonary rehabilitation, patients were randomized 2:1 to receive unilateral lobar placement of endobronchial valves plus optimal medical management or optimal medical management alone. The co-primary endpoint was the mean percent change in FEV1 and six minute walk distance at 180 days. Secondary end-points included mean percent change in St. George's Respiratory Questionnaire score and the mean absolute changes in the maximal work load measured by cycle ergometry, dyspnea (mMRC) score, and total oxygen use per day. Per patient response rates in clinically significant improvement/maintenance of FEV1 and six minute walk distance and technical success rates of valve placement were recorded. Apriori response predictors based on quantitative CT and lung physiology were defined. Conclusion If endobronchial valves improve FEV1 and health status with an acceptable safety profile in advanced emphysema, they would offer a novel intervention for this progressive and debilitating disease. Trial Registration ClinicalTrials.gov: NCT00129584
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Affiliation(s)
- Charlie Strange
- Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Felix JF Herth
- Department of Pneumology and Critical Care Medicine, Thoraxklinik am Universtaetsklinikum, Heidelberg, Germany
| | - Kevin L Kovitz
- Section of Pulmonary, Critical Care and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA, USA
| | - Geoffrey McLennan
- Colleges of Medicine and Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Armin Ernst
- Division of Thoracic Surgery and Interventional Pulmonary, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jonathan Goldin
- Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Marc Noppen
- Interventional Endoscopy Clinic, University Hospital AZ-VUB, Brussels, Belgium
| | - Gerard J Criner
- Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA, USA
| | - Frank C Sciurba
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, USA
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Réduction de volume dans l’emphysème. Traitement endobronchique. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91795-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Oh YM. Bronchoscopic Lung Volume Reduction. Tuberc Respir Dis (Seoul) 2006. [DOI: 10.4046/trd.2006.61.6.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yeon-Mok Oh
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Meurice JC, Similowski T, Roche N. La Revue Des Maladies Respiratoires : une « nouvelle » revue ? Rev Mal Respir 2005; 22:913-7. [PMID: 16222225 DOI: 10.1016/s0761-8425(05)85718-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pinet C. Endoscopie bronchique : quelles nouveautés à l’ATS 2005 ? Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)85685-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dutau H, Thomas P, Pinet C. [Endoscopic lung volume reduction for emphysema: what are the future techniques?]. Rev Mal Respir 2005; 21:1049-52. [PMID: 15767944 DOI: 10.1016/s0761-8425(04)71574-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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