Comparison of efficacy and safety of different types of one-way valves in endoscopic lung volume reduction in patients with severe lung emphysema.

Two valve types have been established in the endoscopic lung volume reduction (ELVR) of severe lung emphysema. These are the intrabronchial umbrella design (UD, Olympus®) and the endobronchial duckbill design (DD, Pulmonx®). The aim of this study is to compare the valve types regarding outcome and safety. Our data originates from three german lung empyhsema centers and was collected in a prospective observational study focusing on lung volume reduction. Two groups were formed depending on the valve type. In both groups, lung function (FEV1, RV, pCO2), 6-minute walking distance (6-MWD), quality of life (SGRQ, CAT), and rate of serious adverse events were recorded at baseline and after three months. A total of 52 patients with a UD and 99 with a DD were treated. Of these, 33 with UD- and 81 with DD-valves received a follow-up. At baseline the DD-group presented with significantly more heterogenous emphysema and a higher RV. Table 1 shows that there were no significant differences between both groups in the delta between baseline and follow-up. For both valves, pneumothorax was the most common adverse event (UD: 4 (8%) vs DD: 11 (11%); p=0.580). <fig><object-id>erj;64/suppl_68/PA4346/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> We saw no significant difference between the two groups in outcome or serious adverse events three months after ELVR in a real clinical setting. The selection of valve types should be based on the individual bronchial anatomy.