How long does endobronchial valve therapy take?

The procedure takes 45-60 minutes. A 2-3 night hospital stay is recommended.

Is endobronchial valve therapy permanent?

Valves can be removed or repositioned when needed. The treatment is considered reversible.

Can I fly after valve therapy?

Due to pneumothorax risk, flying is generally permitted 2-3 weeks after discharge. Individual assessment is required.

Am I still eligible if I currently smoke?

No. Smoking cessation is an absolute prerequisite for valve therapy. A minimum of 4 months of non-smoking is required. Additional note: In clinical practice, patient self-report may not always be sufficient; some centers require a carbon monoxide (CO) breath test or urinary cotinine test to confirm smoking cessation.

Treatments›COPD›Endobronchial Valve Therapy

Endobronchial Valve Therapy

Minimally invasive bronchoscopic approach for severe COPD / Emphysema

Procedure Time

45-60 min

Hospital Stay

2-3 nights

Recovery

2-4 weeks

Success Rate

60-80%

In Short

Endobronchial valve therapy places small one-way valves into the damaged portion of the lung, causing that section to deflate. This allows healthy lung tissue to expand more fully, making breathing easier. No incisions are made.

Who Is a Candidate?

Suitable Candidates

✓ GOLD Stage 3-4 emphysema
✓ Heterogeneous emphysema distribution (confirmed by HRCT)
✓ FEV1 between 15-45%
✓ Complete interlobar fissure (≥90% integrity)
✓ Former smoker (at least 4 months smoke-free)
✓ Persistent breathlessness despite maximal medical therapy

Not Eligible

✗ Active smoking
✗ COPD exacerbation in the last 6 months
✗ Pulmonary hypertension (severe)
✗ Bullous emphysema (large bullae)
✗ FEV1 below 15%

Condition	For Valve	For Coil
Collateral Ventilation	Absolute Barrier	Not a barrier
Homogeneous Emphysema	Usually not suitable	May be suitable
DLCO < 20%	High Risk / Contraindicated	High Risk / Contraindicated
Fissure Integrity	Must be complete	Not important

How the Procedure Works

1. Anesthesia

General anesthesia or sedation is administered; the patient is positioned for bronchoscopy.

2. Bronchoscopy

A flexible bronchoscope is advanced through the mouth into the airways; target bronchi are visualized.

3. Valve Placement

1-4 one-way valves are placed into the target segments (average 3 valves).

Feature	Coil (Spring)	Valve (Flap)
Mechanism	Parenchymal Compression (Tension)	Airway Blockade (Plug)
Units per Lobe	Fixed Target (~10)	Anatomical Requirement (3-5)
Incomplete Placement	May provide partial benefit	Generally results in failure

4. Atelectasis Formation

Valves allow air to exit but block entry; the target segment deflates.

5. Recovery

In-hospital monitoring, chest X-ray checks, and discharge.

Benefits & Expected Outcomes

Minimally invasive procedure — no incisions
Average +25-40 meter improvement in 6-minute walk distance
Significant improvement in dyspnea (mMRC scale)
Valves can be removed if needed (reversible)
Average 15-20% increase in FEV1 and marked reduction in residual volume (RV)
Long-term efficacy proven (LIBERATE, EMPROVE trials)

Risks & Complications

⚠️ As with any medical procedure, there are risks. The following is evidence-based information.

• Pneumothorax (10-15% — most common complication)
• COPD exacerbation (20%)
• Valve migration (5%)
• Hemoptysis (rare)
• Pneumonia (rare)

IMPORTANT NOTE — Timing: Most pneumothorax events occur within the first 48-72 hours, which is why patients must be kept under in-hospital observation during this period. This is critical for patient safety and clinical management.

Recovery Process

Day 0-1

Procedure + intensive monitoring

Day 2-3

Chest X-ray, pneumothorax assessment, discharge

Week 1-2

Home rest, continue inhalers

Month 1

Spirometry check, 6MWT

Month 3

Full functional assessment

Month 6-12

Long-term follow-up, CT scan

Tests Required for Evaluation

Upload the following documents in your Free Evaluation form for remote candidacy assessment:

✓ High-Resolution Chest CT (≤1mm slice, non-contrast, within 1 month, on CD)
✓ Spirometry + DLCO (within 1 month)
✓ 6-Minute Walk Test
✓ Arterial Blood Gas Analysis
✓ Echocardiogram (to rule out pulmonary hypertension)
✓ Complete blood count + biochemistry
✓ Current medication list

Ask a Question

Compare Your Options

Feature	Bronchoscopic (Valve)	Bronchoscopic (coil)	Surgical LVRS
Invasiveness	Minimal	Minimal	High
Recovery	2-4 weeks	3-6 weeks	6-12 weeks
Ideal Emphysema Type	Heterogeneous	Homogeneous/Heterogeneous	Advanced Heterogeneous
Reversible	Yes	Partial	No

Patient Experience

Three months after the procedure, I can walk 350–400 m farther. I can finally take walks in the park with my grandchild.

🇩🇪

Anonymous patient

Germany · 58 years old

Frequently Asked Questions

Scientific References

Got a question before deciding?

Our coordinator is on WhatsApp, ready to help.

Ask a Question

Next Treatment

Endobronchial Coil Treatment

Spiral coil implantation for homogeneous and heterogeneous emphysema