Endobronchial Valve Therapy (EBV) is a minimally-invasive treatment for people who suffer from severe Emphysema an emphysema-like condition that is part of chronic obstructive lung disease (COPD). The therapy can provide the possibility of a cure for those whose life is disrupted by breathing problems and a lack of physical activity. As more people search for non-surgical options for lung diseases, EBV is gaining popularity as a viable alternative.
What Is Endobronchial Valve Therapy
Endobronchial Valve Therapy involves the placing of tiny valves that are one-way in the airways of the lung using the the bronchoscope. The valves are made to stop airflow from the areas of the lung that are infected while permitting trapped fluids and air to flow out. This can help reduce hyperinflation in the lung as well as improve breathing mechanics and improve overall lung function.
The first time it was granted approval by U.S. FDA in 2018, Endobronchial Valve Therapy has revolutionized how we deal with the advanced stage of COPD as well as Emphysema particularly in patients who aren’t suitable for surgery to reduce lung volume.
Why is Endobronchial Valve Therapy Used?
A severe case of emphysema damages the alveoli (air sacs) and can cause overinflation of the lung. This makes it difficult patients breathe out, leading to breath shortness and decreased endurance to exercise. Traditional treatments such as medication and oxygen therapy usually aren’t enough to provide relief.
Endobronchial Valve Therapy offers a method to reduce the pressure of the section of the lung, which allows the healthier areas of the diaphragm and lung to function more effectively.
There are many reasons to consider EBV treatment:
-
Insistent breathlessness despite medical treatment
-
Incapability to complete daily tasks
-
Low quality of life due to hyperinflation of the lungs
-
Want to avoid lung surgery
How Does Endobronchial Valve Therapy Work?
The procedure is carried out by using the flexible bronchoscope that is inserted into the nose or mouth, under moderate sedation or general anesthesia. The doctor makes use of images and measurements to identify which lung lobe is the most affected.
Step-by-step overview:
-
Assessment and selection Prior to beginning the treatment, participants go through CT scans as well as pulmonary function tests in order to find appropriate candidates.
-
Valve Positioning using the bronchoscope One or more Zephyr(r) valves or Spiration(r) valves are installed within the airways in the damaged lobe.
-
Airflow Control The valves with one-way openings stop air from entering the lobe that is diseased however, they allow trapped air and mucus out.
-
Lung Deflation As time passes the area treated shrinks and shrinks, allowing room for the healthy lung tissue to grow.
Benefits of Endobronchial Valve Therapy
Studies conducted in clinical trials and in real-world settings have revealed a number of positive effects of this therapy
-
Improved lung function (increased FEV1)
-
Reducing dyspnea (shortness of breath)
-
Greater exercise tolerance
-
Enhances the quality of your life
-
A short recovery period (non-surgical method)
-
A brief hospital stay (usually 3 to 5 days)
Many patients have reported having the ability to walk longer distances, do household chores and have better sleep following the procedure.
Who is a Candidate for Endobronchial Valve Therapy?
This treatment is most suitable to patients with severe Emphysema who meet the following conditions:
Criteria for eligibility include:
-
The diagnosis is heterogeneous Emphysema (where the damage is not uniform across the lung lobes)
-
Very severe trapped air in addition to Hyperinflation (confirmed by testing)
-
No significant collateral ventilation (airflow between lung lobes)
-
Non-smoker or ex-smoker
-
Not able to adequately respond to medical treatments
A pulmonologist or a lung specialist conducts a thorough evaluation prior to suggesting this procedure.
Risks and Potential Side Effects
While Endobronchial Valve Therapy is minimally invasive, it is not without risk factors:
-
Pneumothorax (collapsed lung) occurs in 20-30% cases within days following valve installation.
-
The respiratory infections including pneumonia or bronchitis
-
Sputum or coughing up more
-
Valve blockage or migration
Most issues can be managed with prompt medical treatment. Patients are closely monitored for a period of 3-5 days after the procedure to deal with any adverse events.
Recovery and Post-Procedure Care
After valve placement, patients usually are admitted to the hospital to watch. The recovery process is generally quick as compared to surgical options.
Post-procedure tips:
-
Imaging follow-up (X-ray or CT scan) to determine the valve’s position
-
Use oxygen or inhalers as prescribed when required.
-
Do not engage in strenuous activities for the next 1-2 weeks
-
Rehab of the respiratory tract for improved endurance and breathing
-
Make sure you attend regular check-ups to observe the valve’s function
Long-Term Outcomes and Success Rates
Numerous studies such as those of the studies LIBERATE as well as EMPROVE have shown that a large percentage of patients notice significant improvement in their breathing and activity levels.
According to the most recent statistics:
-
A majority of patients demonstrated an improvement in lung function.
-
Many of them benefited for up to a year or more
-
Some valves needed additional adjustments or replacements
Alternatives to Endobronchial Valve Therapy
Although EBV therapy has been shown to be effective however, other options could be contemplated dependent on the condition of the patient:
-
Lung Volume Reduction Surgery (LVRS)
-
Bronchoscopic Thermal Vapor Ablation
-
Medicine management (bronchodilators and oxygen therapy, steroids)
-
Lung transplantation (in extreme cases)
A multidisciplinary approach will give you the most effective treatment plan for each patient.
Conclusion
Endobronchial Valve Therapy is a breakthrough for those who suffer from severe emphysema or COPD. Through its non-surgical approach, speedy recovery, and huge functional advantages, it provides new hope for patients who were who were previously confined by their illness.
If you or someone in your family is experiencing breathlessness as a result of advanced emphysema, consult an pulmonologist to determine whether EBV treatment is the best option.
