BACKGROUND: Bronchoscopic lung-volume reduction with the use of one-way endobronchial valves is a potential treatment for @entity1 with severe @entity2415 . To date, the benefits have been modest but have been hypothesized to be much larger in @entity1 without interlobar collateral ventilation than in those with collateral ventilation. METHODS: We randomly assigned @entity1 with severe @entity2415 and a confirmed absence of collateral ventilation to bronchoscopic endobronchial-valve treatment (EBV group) or to continued standard medical care (control group). Primary outcomes were changes from baseline to 6 months in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and 6-minute walk distance. RESULTS: Eighty-four @entity1 were recruited, of whom 16 were excluded because they had collateral ventilation (13 @entity1 ) or because lobar segments were inaccessible to the endobronchial valves (3 @entity1 ). The remaining 68 @entity1 (mean [  SD] age, 59  9 years; 46 were @entity1 ) were randomly assigned to the EBV group (34 @entity1 ) or the control group (34). At baseline, the FEV1 and FVC were 29  7% and 77  18% of the predicted values, respectively, and the 6-minute walk distance was 374  86 m. Intention-to-treat analyses showed significantly greater improvements in the EBV group than in the control group from baseline to 6 months: the increase in FEV1 was greater in the EBV group than in the control group by 140 ml (95% confidence interval [CI], 55 to 225), the increase in FVC was greater by 347 ml (95% CI, 107 to 588), and the increase in the 6-minute walk distance was greater by 74 m (95% CI, 47 to 100) (P<0.01 for all comparisons). By 6 months, 23 serious adverse events had been reported in the EBV group, as compared with 5 in the control group (P<0.001). One @entity1 in the EBV group died. Serious treatment-related adverse events in this group included pneumothorax (18% of @entity1 ) and events requiring valve replacement (12%) or removal (15%). CONCLUSIONS: Endobronchial-valve treatment significantly improved pulmonary function and exercise capacity in @entity1 with severe @entity2415 characterized by an absence of interlobar collateral ventilation. (Funded by the Netherlands Organization for Health Research and Development and the University Medical Center Groningen; Netherlands Trial Register number, NTR2876.).

Endobronchial Valves for XXXX without Interlobar Collateral Ventilation.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'women'] @entity2415 :: ('MESH:D004646', 'Disease') :: ['emphysema']
@entity2415 :: (MESH:D004646,Disease) :: ['Emphysema']
