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Background: Chronic obstructive pulmonary disease (COPD) causes permanent lung damage and is a global health issue. Bronchoscopic Lung Volume Reduction (BLVR) with Zephyr valves has increased COPD treatment choices for individuals with persistent symptoms despite maximal drug therapy.
Objectives: This systematic review and meta-analysis evaluated available Zephyr valve data in severe emphysema patients.
Data And Methods: We searched Cochrane, PubMed, Google Scholar, Lilacs, and Science Direct extensively and included eight randomized control trials (RCTs).
Results: This meta-analysis comprises 1083 patients 669 Zephyr valve-treated and 414 control. The mean difference in 6-minute walking distance was 37.53 meters (95% CI: 22.14-52.90, < 0.001). Statistically significant improvements were also observed in FEV1 predicted percentage (mean difference: 13.64, 95% CI: 8.51-18.77, < 0.001) and BODE index change (mean difference: -0.79, 95% CI: -1.33 to 0.26, < 0.05), mMRC dyspnea scale (mean difference: -0.27, 95% CI: -0.55 to 0.02, < 0.01) and residual volume (mean difference: -0.14, 95% CI: -0.64 to 0.35, < 0.01). The quality of life measured by SGRQ also improved significantly (mean difference: -6.69, 95% CI: -9.69, -4.23, < 0.001). While COPD exacerbation rates (OR:1.41, 95% CI: 0.87-2.30, > 0.05) and pneumonia rates (OR: 1.72, 95% CI: 0.7-4.23, > 0.05) were similar between valve and control groups, pneumothorax risk was significantly higher in the treatment arm (OR: 11.06, 95% CI: 4.10-29.80, < 0.001). However, there was no significant difference in all-cause mortality between the groups (OR: 1.69; 95% CI: 0.53-5.38, > 0.38).
Conclusion: Zephyr valves may improve lung function, exercise capacity, and quality of life in patients suffering from severe emphysema. However, the increased risk of pneumothorax requires careful patient selection and rigorous post-intervention monitoring.
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http://dx.doi.org/10.1097/MS9.0000000000003409 | DOI Listing |
Ann Med Surg (Lond)
July 2025
Department of Medicine, University of Kentucky, College of Medicine, Bowling Green, Kentucky, USA.
Background: Chronic obstructive pulmonary disease (COPD) causes permanent lung damage and is a global health issue. Bronchoscopic Lung Volume Reduction (BLVR) with Zephyr valves has increased COPD treatment choices for individuals with persistent symptoms despite maximal drug therapy.
Objectives: This systematic review and meta-analysis evaluated available Zephyr valve data in severe emphysema patients.
Clin Chest Med
June 2025
Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah, 30 North Mario Capecchi Drive, 2nd Floor North, Salt Lake City, UT 84112, USA. Electronic address:
Bronchoscopic lung volume reduction (BLVR) is an option for patients with advanced emphysema with hyperinflation when symptomatic on maximal medical therapy including inhaled therapies, oxygen as indicated, and conditioned with pulmonary rehabilitation. The procedure is complicated by pneumothoraces requiring admission for observation for 3 to 5 days following the procedure. In younger patients, BLVR may be used as a bridge to lung transplant and can also be used as a bridge to lung volume reduction surgery when benefit wanes.
View Article and Find Full Text PDFEgypt Heart J
April 2025
Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India.
Background: Transcatheter stenting has become the preferred treatment for native and recurrent coarctation of aorta (CoA), but complications such as stent migration occur in approximately 5% of cases. Proximal stent migration is particularly challenging and often requires surgical intervention. This report highlights the successful transcatheter management of proximal stent migration during CoA stenting in a high-risk patient.
View Article and Find Full Text PDFInt J Chron Obstruct Pulmon Dis
May 2025
Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Ensuring proper placement of one-way endobronchial valves is a vital step in achieving successful bronchoscopic lung volume reduction. The ability to navigate into sharply angled airways may be limited by the maximal flexion capability of bronchoscopes. We sometimes encounter difficult anatomical situations, causing a challenging, or sometimes even impossible placement of the EBV in the appropriate position due to steep bronchial bifurcation angles, particularly in the apical segments.
View Article and Find Full Text PDFRespir Med Case Rep
December 2024
Section of Pulmonary, Critical Care and Sleep Medicine Carilion Clinic, Virginia Tech School of Medicine, USA.
Chronic obstructive lung disease is the third leading cause of death worldwide. It affects the airways and lung parenchyma leading to emphysema. Bronchoscopic lung volume reduction is another strategy that aims to reduce air trapping and hyperinflation, leading to improvement in symptoms and pulmonary function.
View Article and Find Full Text PDF