1. Optimizing clinical outcomes for bronchoscopic lung volume reduction with Zephyr® valves.
- Author
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Koster TD, Shah PL, Valipour A, Criner GJ, Herth FJF, Sue R, Hogarth DK, Martin RT, Mahajan AK, Alalawi R, Kopas L, Cohen A, Wood DE, Kurman J, Shargill NS, Dransfield M, Slebos DJ, and Perch M
- Subjects
- Humans, Treatment Outcome, Tomography, X-Ray Computed, Bronchoscopy methods, Pulmonary Emphysema surgery, Pulmonary Emphysema physiopathology, Pneumonectomy methods
- Abstract
Bronchoscopic lung volume reduction treatment with Zephyr one-way valves is an effective guideline-based treatment option for patients with severe emphysema and hyperinflation. However, in some cases the treatment response is less than anticipated or there might be a loss of initial treatment effect. Reasons for the lack of response can include incorrect assessment of collateral ventilation, improper valve placement, or patient related factors. Loss of initial benefit can be due to granulation tissue formation and subsequent valve dysfunction, or there may be side effects such as excessive coughing or infectious problems. Careful follow-up after treatment with valves is important and evaluation with a CT scan and/or bronchoscopy is helpful if there is no improvement after treatment or loss of initial benefit. This paper aims to describe the most important causes and provide a strategy of how to approach and manage these patients., Competing Interests: Declaration of competing interest PS declares consulting fees and educational fees. AV declares educational fees. GJC declares grants/contract, consulting fees, educational fees and participation on a DSMB. FJFH declares educational and consulting fees. DKH declares consulting fees and educational fees. AM declares consulting fees and educational fees. AC declares consulting fees and educational fees. MD declares consulting fees and support for attending meetings by GSK. JK declares consulting fees and educational fees. NS is a full-time employee of Pulmonx Corporation and declares stock options. DJS declares grants/contracts, consulting fees, educational fees and support for attending meetings. MP declares grants, consulting fees, educational fees, support for attending meetings and leadership or fiduciary roles. Regarding the consensus opinion meeting: PS, FJFH, RS, DH, RM, AM, RA, LK, AC, JK, DJS, and MP received travel and accommodation support and honoraria from Pulmonx. AV received an honorarium from Pulmonx. DEW, MD, GJC and TDK have no conflict., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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