The Endobronchial Valve (EBV) Treatment is non-invasive treatment option that is primarily utilized to aid patients suffering from severely Emphysema as well as chronic obstructive lung disease (COPD). This treatment uses small valves with one-way connections installed in the airways to direct the flow of air and lessen hyperinflation within affected areas of the lung. By separating those areas most affected healthy lung tissue will function better which improves breath quality, exercise capacity and the quality of your life..

Thanks to advances in the field of pulmonary intervention, various types of endobronchial valve therapy are available, each one adapted to the specific needs of the patient and the anatomy of the lungs.

Why is Endobronchial Valve Therapy Needed?

Patients suffering from advanced Emphysema frequently experience air trapped in their lungs. This makes breathing difficult and causes breathing difficulties, exhaustion and a decrease in endurance. Traditional treatments such as inhalers and medication may not be effective after a certain point. In these cases the endobronchial valves provide an non-surgical lung volume reduction technique that could:

Improve the airflow in healthier lung regions
Enhance oxygen exchange
Reduce breathlessness
Increase the endurance of your workout

How Does Endobronchial Valve Therapy Work?

Endobronchial valves can be placed during the Bronchoscopic surgery which means that there are no incisions made. They are valves that are one-way let air out of the affected part of the lung when exhaling however they block air from inhaling. As time passes, this section of lung shrinks (atelectasis), allowing healthy lung sections to grow and function more effectively.

Types of Endobronchial Valve Therapy

There are two FDA-approved kinds of valves for endobronchial flow employed within clinical settings. Each valve has its own unique functional and structural features, yet works on the same concept that is reduced lung volume.

1. Zephyr(r) Endobronchial Valve Therapy

Zephyr valves that were developed by Pulmonx are among the most commonly utilized and extensively studied endobronchial valves. They are FDA-approved to treat severe emphysema, and are regarded as the gold standard in a number of pulmonary clinics.

Key Features:

Self-expanding Nitinol (a kind made of alloy metal) frame
A one-way membrane of silicone to regulate the flow of air
Utilized with a flexible bronchoscope into airways that lead to damaged lung tissue

Advantages:

Achieved improvements of Lung function (FEV1), fitness capacity and the quality of life
Breathlessness and hyperinflation reduced
Very minimally invasive; no need for a surgical incision

Perfect for:

Patients suffering from an emphysema that is heterogeneous (more damage to one lobe than the others)
Patients with no ventilation between the lobes (assessed through chartis(tm) system). Chartis(tm) method)

2. Spiration(r) Valve System (SVS)

Its Spiration valve made through Olympus Respiratory America, is another FDA-approved valve designed to serve similar functions, but with distinct style.

Key Features:

Umbrella-shaped composed of Nitinol
Anchors against the airway wall and ensures an ideal fit
Often, it is used for the reduction of lung volume in a specific area or for the emergency management of air leaks

Advantages:

Effective in reducing lung hyperinflation
Easier placement due to umbrella design
Utilized for the treatment of both persistent lung diseases as well as after-surgery air leak closure

The ideal candidate for:

Patients who suffer from two types of homogeneous as well as homogeneous Emphysema
The procedure is ideal for controlling air leaks that persist following trauma or surgery.

Other Emerging Valve Technologies (Under Study)

Even though Zephyr as well as Spiration are the most commonly used valves approved by FDA currently under investigation, there is a growing interest in different types of endobronchial valves, including flexible styles, biodegradable materials as well as the use of robotics to assist in placement. They are under the clinical trial or in limited use phases, but have promise for increasing precision and reducing complications.

Benefits of Endobronchial Valve Therapy

Non-surgical method No incisions nor stitches are needed
Rapid recovery Patients are usually discharged within a couple of days
Better lung function Research has shown an improvement of 20-30% in FEV1.
Improved living quality The symptoms of fatigue and breathlessness
Repeatable process Valves can be relocated or removed when required

Risks and Complications

Like all medical procedures, EBV therapy carries some risk factors, like:

Pneumothorax (collapsed lung) – the most frequent congenital
Valve displacement or migration
Infection or inflammation of the airways
A rise in cough or mucus production

However, they are treatable by a close monitoring and prompt intervention.

Who is a Candidate for Endobronchial Valve Therapy?

Ideal candidates include those who:

Have you had severe Emphysema been confirmed by CT scans
You may experience significant breathlessness, as well as a low exercise tolerance
Do not smoke, or the courage to stop smoking cigarettes
Display the smallest amount of collateral ventilation
Do not qualify for a lung transplant or volume reduction surgery.

Procedure & Recovery

Before the Procedure:

In-depth imaging (HRCT) to evaluate the lung’s structure
Tests of the function of the lungs
Assessment of the Collateral Ventilation using Chartis system Chartis System

During the Procedure:

The procedure is performed under general anesthesia or conscious sedation.
Duration 30-60 minutes
Hospitalization in short or outpatient form (1-3 days)

Post-Procedure Care:

Watch for 24 to 48 hours for the presence of pneumothorax
Rehab for the lungs is suggested
Regular follow-ups for lung function and chest imaging tests

Conclusion

Endobronchial Valve Therapy is a major advancement in the treatment of severe emphysema as well as COPD as it offers an alternative that is minimally invasive to surgery. Its Zephyr(r) as well as the Spiration(r) valves represent the two primary valves currently approved and being used in clinical trials, both providing distinct benefits depending on the anatomy of the lung and severity of the disease.

As technology improves, new valves and methods could enhance outcomes and increase treatments options. At present, careful patient selection and expert pulmonology direction are the mainstays of a successful endobronchial valve treatment.