A multicenter pilot study of a bronchial valve for the treatment of severe emphysema

Respiration. 2010;79(3):222-33. doi: 10.1159/000259318. Epub 2009 Nov 17.


Background: Chronic obstructive pulmonary disease (COPD) affects millions of people and has limited treatment options. Surgical treatments for severe COPD with emphysema are effective for highly selected patients. A minimally invasive method for treating emphysema could decrease morbidity and increase acceptance by patients.

Objective: To study the safety and effectiveness of the IBV(R) Valve for the treatment of severe emphysema.

Methods: A multicenter study treated 91 patients with severe obstruction, hyperinflation and upper lobe (UL)-predominant emphysema with 609 bronchial valves placed bilaterally into ULs.

Results: Valves were placed in desired airways with 99.7% technical success and no migration or erosion. There were no procedure-related deaths and 30-day morbidity and mortality were 5.5 and 1.1%, respectively. Pneumothorax was the most frequent serious device-related complication and primarily occurred when all segments of a lobe, especially the left UL, were occluded. Highly significant health-related quality of life (HRQL) improvement (-8.2 +/- 16.2, mean +/- SD change at 6 months) was observed. HRQL improvement was associated with a decreased volume (mean -294 +/- 427 ml, p = 0.007) in the treated lobes without visible atelectasis. FEV(1), exercise tests, and total lung volume were not changed but there was a proportional shift, a redirection of inspired volume to the untreated lobes. Combined with perfusion scan changes, this suggests that there is improved ventilation and perfusion matching in non-UL lung parenchyma.

Conclusion: Bronchial valve treatment of emphysema has multiple mechanisms of action and acceptable safety, and significantly improves quality of life for the majority of patients.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Blood Gas Analysis
  • Bronchoscopy
  • Device Removal
  • Exercise Test
  • Female
  • Humans
  • Lung Volume Measurements
  • Male
  • Middle Aged
  • Oxygen / therapeutic use
  • Pilot Projects
  • Pneumonia / epidemiology*
  • Pneumonia / etiology
  • Pneumothorax / etiology*
  • Postoperative Complications / epidemiology*
  • Prospective Studies
  • Prostheses and Implants* / adverse effects
  • Pulmonary Circulation
  • Pulmonary Emphysema / diagnostic imaging
  • Pulmonary Emphysema / mortality
  • Pulmonary Emphysema / surgery*
  • Quality of Life
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • United States / epidemiology


  • Oxygen