Delayed functional improvement after near-fatal bleeding complication following endobronchial valve therapy for emphysema


  • Sergio Baldi | S. Giovanni Battista Hospital, Italy.
  • Francesco Coni S. Giovanni Battista Hospital, Italy.
  • Giorgio Limerutti S. Giovanni Battista Hospital, Italy.
  • Massimo Baccega S. Giovanni Battista Hospital, Italy.
  • Enrico Ruffini S. Giovanni Battista Hospital, Italy.
  • Paolo Solidoro S. Giovanni Battista Hospital, Italy.


Endoscopic treatment of emphysema is supported by different methods, including valves, coils and sealants. The mechanism is mainly related to volume reduction of targeted area. Endobronchial valves (EBV) appear the most studied method. In a multicentre randomised study, placement of unidirectional endobronchial valves resulted in a statistically significant functional improvement in the treated cohort compared to the control. Adverse events, occurring post procedure, included COPD exacerbations, haemoptysis, pneumothorax and pneumonia. In our centre we treated 30 patients, between January 2009 and February 2012, with variable improvement of lung function and only mild postoperative complications. The case we report here appears very interesting for the unusual near-fatal complication (massive alveolar haemorrage) followed by delayed strong functional improvement (FEV1 +23%; RV -18%; 6MWD:+33%) six months after the valve placement. This improvement could be attributable to the EBV procedure, but an alternative explanation is that the lung volume reduction may have been enhanced by the complication itself, as an effect of alveolar collapse.



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Pneumology - Case Reports
Bronchoscopic lung volume reduction, lung volume reduction, emphysema.
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How to Cite
Baldi, Sergio, Francesco Coni, Giorgio Limerutti, Massimo Baccega, Enrico Ruffini, and Paolo Solidoro. 2016. “Delayed Functional Improvement After Near-Fatal Bleeding Complication Following Endobronchial Valve Therapy for Emphysema”. Monaldi Archives for Chest Disease 81 (1-2).