TY - JOUR
T1 - Use of One-Way Intrabronchial Valves in Air Leak Management after Tube Thoracostomy Drainage
AU - Gilbert, Christopher R.
AU - Casal, Roberto F.
AU - Lee, Hans J.
AU - Feller-Kopman, David
AU - Frimpong, Bernice
AU - Dincer, H. Erhan
AU - Podgaetz, Eitan
AU - Benzaquen, Sadia
AU - Majid, Adnan
AU - Folch, Erik
AU - Gorden, Jed A.
AU - Chenna, Praveen
AU - Chen, Alex
AU - Abouzgheib, Wissam
AU - Sanny Nonyane, Bareng Aletta
AU - Yarmus, Lonny B.
N1 - Publisher Copyright:
© 2016 The Society of Thoracic Surgeons.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Background A persistent air leak represents significant clinical management problems, potentially affecting morbidity, mortality, and health care costs. In 2008, a unidirectional, intrabronchial valve received humanitarian device exemption for use in managing prolonged air leak after pulmonary resection. Since its introduction, numerous reports exist but no large series describe current utilization or outcomes. Our aim was to report current use of intrabronchial valves for air leaks and review outcome data associated with its utilization. Methods A multicenter, retrospective review of intrabronchial valve utilization from January 2013 to August 2014 was performed at eight centers. Data regarding demographics, valve utilization, and outcomes were analyzed. Results We identified 112 patients undergoing evaluation for intrabronchial valve placement, with 67% (75 of 112) undergoing valve implantation. Nearly three quarters of patients underwent valve placement for off-label usage (53 of 75). A total of 195 valves were placed in 75 patients (mean 2.6 per patient; range, 1 to 8) with median time to air leak resolution of 16 days (range, 2 to 156). Conclusions We present the largest, multicenter study of patients undergoing evaluation for intrabronchial valve use for air leak management. Our data suggest the majority of intrabronchial valve placements are occurring for off-label indications. Although the use of intrabronchial valves are a minimally invasive intervention for air leak management, the lack of rigorously designed studies demonstrating efficacy remains concerning. Prospective randomized controlled studies remain warranted.
AB - Background A persistent air leak represents significant clinical management problems, potentially affecting morbidity, mortality, and health care costs. In 2008, a unidirectional, intrabronchial valve received humanitarian device exemption for use in managing prolonged air leak after pulmonary resection. Since its introduction, numerous reports exist but no large series describe current utilization or outcomes. Our aim was to report current use of intrabronchial valves for air leaks and review outcome data associated with its utilization. Methods A multicenter, retrospective review of intrabronchial valve utilization from January 2013 to August 2014 was performed at eight centers. Data regarding demographics, valve utilization, and outcomes were analyzed. Results We identified 112 patients undergoing evaluation for intrabronchial valve placement, with 67% (75 of 112) undergoing valve implantation. Nearly three quarters of patients underwent valve placement for off-label usage (53 of 75). A total of 195 valves were placed in 75 patients (mean 2.6 per patient; range, 1 to 8) with median time to air leak resolution of 16 days (range, 2 to 156). Conclusions We present the largest, multicenter study of patients undergoing evaluation for intrabronchial valve use for air leak management. Our data suggest the majority of intrabronchial valve placements are occurring for off-label indications. Although the use of intrabronchial valves are a minimally invasive intervention for air leak management, the lack of rigorously designed studies demonstrating efficacy remains concerning. Prospective randomized controlled studies remain warranted.
UR - http://www.scopus.com/inward/record.url?scp=84957381430&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84957381430&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2015.10.113
DO - 10.1016/j.athoracsur.2015.10.113
M3 - Article
C2 - 26876341
AN - SCOPUS:84957381430
SN - 0003-4975
VL - 101
SP - 1891
EP - 1896
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -