A Randomized Study of Endobronchial Valves for Advanced Emphysema

One of the characteristics of severe emphysema is hyperinflation of regions of the lungs. In this trial, valves that prevented air entry but allowed air to escape were placed in lobar airways. Patients receiving endobronchial valves had modest improvements in lung function and exercise performance. Emphysema is a leading cause of disability and death. Lung-volume–reduction surgery, in which selected areas of hyperinflated lungs are resected, improves exercise tolerance and prolongs life in selected patients. However, concern regarding the risk of perioperative death and complications contributes to underutilization. 1 – 4 Less invasive bronchoscopic techniques that are based on the presumed physiological effects of lung-volume–reduction surgery have been developed. 5 – 10 Early uncontrolled trials using unidirectional valves placed in selected lung airways to block regional inflation while allowing exhalation have reported improvements in lung function and symptoms with modest risk, including distal pneumonia or pneumothorax. 5 , 6 , 9 , 11 – . . .