Long-Term Follow-Up of Intralobar Bullae After Endobronchial Valve Treatment for Emphysema

Int J Chron Obstruct Pulmon Dis. 2022 Aug 2:17:1735-1742. doi: 10.2147/COPD.S363490. eCollection 2022.

Abstract

Endoscopic lung volume reduction using unidirectional endobronchial valves is a new technique in the treatment of patients with severe emphysema. However, the movements of the thoracic structures after endobronchial valves insertion are still unpredictable We report the unusual outcome of six patients after valves insertion in the left upper lobe. They all developed a complete atelectasis of the target lobe, a pneumothorax and sequential genuine bullae in the treated left lung of unknown etiology. The chest CT scan prior to the valves insertion was unremarkable. Three patients developed an air-liquid level in the bullae the day before a bacterial infection of their left lower lobe. The three other patients had an uneventful spontaneous resolution of their bullae at long-term follow-up. Therefore, a conservative attitude should be followed in this particular setting.

Keywords: chest CT scanner; chest tube drainage; endoscopic lung volume reduction; pneumothorax.

Publication types

  • Case Reports

MeSH terms

  • Blister / diagnostic imaging
  • Blister / etiology
  • Blister / surgery
  • Bronchoscopy / adverse effects
  • Emphysema* / complications
  • Follow-Up Studies
  • Humans
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods
  • Pneumothorax* / diagnostic imaging
  • Pneumothorax* / etiology
  • Pneumothorax* / surgery
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Pulmonary Emphysema* / diagnostic imaging
  • Pulmonary Emphysema* / etiology
  • Pulmonary Emphysema* / surgery
  • Treatment Outcome