Endobronchial valve placement and balloon occlusion for persistent air leak: Procedure overview and new current procedural terminology codes for 2013

摘要

Unidirectional endobronchial valves, originally studied for potential treatment of emphysema, have emerged as a useful intervention for patients with persistent air leak from the lung. The procedure is accomplished via bronchoscopy in a patient who already has a chest tube in place for management of the air leak. It uses an occluding balloon to determine the specifi c airway(s) leading to the leak by impact on airfl ow and subsequent placement of removable valve(s) in one or more segment or subsegments to decrease fl ow across the leak to allow for healing of the fi stula. Specifi c US Food and Drug Administration-approved criteria for placement and removal of these valves via a Humanitarian Device Exemption are discussed along with reported outcomes. Current Procedural Terminology codes effective for 2013 that are specifi c to the procedure are reviewed.