Implementing bronchoscopic lung volume reduction using one-way endobronchial valves in a Dutch university hospital, retrospective real-life outcomes at 3 months

Abstract

Introduction: Bronchoscopic lung volume reduction (BLVR) using one-way endobronchial valves (EBV) has become a guideline treatment in patients with advanced emphysema. Evidence for this minimally invasive treatment comes from well-designed controlled trials mostly conducted in high-volume specialised intervention centres. Little is known about real-life outcomes in hospitals implementing this novel treatment. Aim: This study aimed to evaluate whether the implementation of BLVR in our university hospital yields clinically significant outcomes. Methods: Retrospective evaluation of patients treated with EBV was conducted between January 2016 and August 2019. FEV1, residual volume (RV) and 6 minute walking distance (6MWD) were measured at baseline and 3 months. Results: Of 350 patients screened, 67 (19%) were identified as treatment candidates and underwent bronchoscopic assessment and if suitable, valves were placed in the same session. In 12 patients no intervention was performed due to collateral ventilation (n=11) or unexpected endobronchial lesion (n=1). 55 patients (15%) were treated with EBV. 10 patients did not have complete follow-up, of which 6 patients had their valves removed due to, lack of benefit (n=4) or severe pneumothorax (n=2). 45 patients had complete follow-up at 3 months. On average, they showed a change in FEV1 of +190(±140)ml, in RV of -770(±790)ml and +37(±65)meters on the 6MWD, p Conclusion: Implementing BLVR with EBV is feasible and effective. 15% of screened patients were eligible of whom 82% retained EBV at three months with clinical meaningful improvements.