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The following is a summary of “Efficacy and safety of simultaneous combined Zephyr and Spiration valve therapy in patients with advanced pulmonary emphysema,” published in the August 2024 issue of Pulmonology by Dittrich et al.

Endoscopic lung volume reduction using valves represents a minimally invasive approach for managing severe pulmonary emphysema. Among the available options, the Zephyr and Spiration valves are two distinct systems that can be implanted concurrently within the same procedure. This study aimed to evaluate the impact of combined valve therapy on lung function, exercise capacity, and patient-reported outcomes.

Researchers performed a retrospective analysis of 108 patients who underwent simultaneous implantation of Zephyr and Spiration valves. The selection and number of valves implanted were tailored to each patient’s anatomical requirements. The effects of the combined treatment on lung function, exercise capacity, and atelectasis formation, along with any associated complications, were assessed at 90 and 180 days post-treatment (90d-FU and 180d-FU).

At the 90-day follow-up (n=90), the mean change in forced expiratory volume in 1 second (FEV1) was 86.7±183.7 mL, and residual volume (RV) showed a mean reduction of -645.3±1276.5 mL, with responder rates of 39.8% and 46.5%, respectively. Complete atelectasis was observed in 16.7% of patients, while partial atelectasis occurred in 25.5%. The six-minute walk test demonstrated an average increase of 27.00 meters (range: -1.50 to 68.50 meters). The incidence of pneumothorax at six months was 10.2%, aligning with rates reported in randomized controlled trials (RCTs). However, due to the inclusion of high-risk patients in this cohort, there was a notably higher incidence of severe COPD exacerbations (21.3%) and pneumonia (12.0%) compared to RCTs.

The simultaneous implantation of Zephyr and Spiration valves yielded significant clinical and functional outcomes improvements, with a manageable risk profile. This combined valve approach holds promise as a viable option for endoscopic lung volume reduction in patients with severe emphysema, potentially enhancing the overall effectiveness of the treatment strategy.

Source: sciencedirect.com/science/article/abs/pii/S095461112400235X