Endobronchial valves for severe emphysema

Eur Respir Rev. 2019 Apr 17;28(152):180121. doi: 10.1183/16000617.0121-2018. Print 2019 Jun 30.


The results of the randomised controlled trials investigating the bronchoscopic lung volume reduction treatment using endobronchial valves (EBV) are promising, and have led to their inclusion in treatment guidelines, US Food and Drug Administration approval and inclusion in routine care in an increasing number of countries. The one-way valve treatment has advanced and is now a regular treatment option. However, this new phase will lead to new challenges in terms of implementation. We believe that key issues in future research concern advanced patient selection, improved methods for target lobe selection, increased knowledge on the predictive risk of a pneumothorax, positioning of pulmonary rehabilitation in conjunction with the EBV treatment, the positioning of lung volume reduction surgery versus EBV treatment, and the long-term efficacy, adverse events, impact on exacerbations and hospitalisations, costs and survival. Hopefully, the increasing number of patients treated, the setup of (inter)national registries and future research efforts will further optimise all aspects of this treatment.

Publication types

  • Review

MeSH terms

  • Bronchoscopy / adverse effects
  • Bronchoscopy / instrumentation*
  • Humans
  • Lung / physiopathology
  • Lung / surgery*
  • Prosthesis Design
  • Prosthesis Implantation / adverse effects
  • Prosthesis Implantation / instrumentation*
  • Pulmonary Emphysema / diagnosis
  • Pulmonary Emphysema / physiopathology
  • Pulmonary Emphysema / surgery*
  • Randomized Controlled Trials as Topic
  • Recovery of Function
  • Treatment Outcome