Peri-procedural vs. post-procedural mortality after endobronchial valve treatment for severe emphysema: a systematic review and meta-analysis of randomized controlled trials.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Peri-procedural vs. post-procedural mortality after endobronchial valve treatment for severe emphysema: a systematic review and meta-analysis of randomized controlled trials.
Συγγραφείς:	Mari PV; Internal Medicine, San Carlo di Nancy Hospital, Rome, Italy., Ielo S; Pulmonology and Respiratory Intensive Care Unit, Ospedale San Donato, USL Toscana Sud-Est, Arezzo, Italy., Coppola A; Ospedale San Filippo Neri-ASL Roma 1, UOC Pneumologia, Rome, Italy.; Faculty of Medicine and Surgery, UniCamillus International Medical University of Rome, Rome, Italy., Ricci A; Division of Pneumology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, Italy., Licata MA; Pulmonology Unit and UTIR, Ospedale Civile San Salvatore, L'Aquila, Italy., Lipsi R; Department of Pulmonology and Sub-Intensive Respiratory Unit, Santa Maria della Misericordia Hospital, Perugia, Italy., Dodaj M; Department of Pulmonology and Sub-Intensive Respiratory Unit, Santa Maria della Misericordia Hospital, Perugia, Italy., Gennari F; Department of Medicine and Surgery, Section of Otorhinolaryngology, Santa Maria della Misericordia Hospital, Perugia, Italy., De Corso E; Department of Medicine and Surgery, Section of Otorhinolaryngology, Santa Maria della Misericordia Hospital, Perugia, Italy., Ojetti V; Internal Medicine, San Carlo di Nancy Hospital, Rome, Italy.; Faculty of Medicine and Surgery, UniCamillus International Medical University of Rome, Rome, Italy., Scala R; Pulmonology and Respiratory Intensive Care Unit, Ospedale San Donato, USL Toscana Sud-Est, Arezzo, Italy., Baglioni S; Department of Pulmonology and Sub-Intensive Respiratory Unit, Santa Maria della Misericordia Hospital, Perugia, Italy., Bezzi M; Pulmonology Department, ASST Spedali Civili, Brescia, Italy., Carriera L; Department of Pulmonology and Sub-Intensive Respiratory Unit, Santa Maria della Misericordia Hospital, Perugia, Italy.; Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Roma, Italy.
Πηγή:	Expert review of medical devices [Expert Rev Med Devices] 2026 Sep; Vol. 23 (9), pp. 1105-1113. Date of Electronic Publication: 2026 Jul 27.
Τύπος έκδοσης:	Comparative Study; Journal Article; Meta-Analysis; Systematic Review
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Taylor & Francis Country of Publication: England NLM ID: 101230445 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1745-2422 (Electronic) Linking ISSN: 17434440 NLM ISO Abbreviation: Expert Rev Med Devices Subsets: MEDLINE
Imprint Name(s):	Publication: 2015- : Abingdon, Oxford : Taylor & Francis Original Publication: London : Future Drugs Ltd.
Ιατρικοί όροι (MeSH):	Pulmonary Emphysema/surgery , Pulmonary Emphysema/mortality , Randomized Controlled Trials as Topic*, Humans
Περίληψη:	Introduction: Endobronchial valve (EBV) treatment improves functional outcomes in severe emphysema, but its effect on mortality remains uncertain. Recent evidence suggested increased mid-term mortality with EBV, without distinguishing early peri-procedural deaths from later post-procedural mortality. Methods: PubMed, Embase, Cochrane CENTRAL, and Web of Science were systematically searched from database inception through March 2026 for randomized controlled trials comparing EBV with standard of care (SoC) in patients with severe emphysema. The main outcome was overall mortality, further stratified into peri-procedural mortality (≤90 days) and post-procedural mortality (>90 days). Results: Six randomized controlled trials involving 819 patients (515 EBV, 304 SoC) were included. Peri-procedural mortality was significantly higher with EBV (Peto OR 3.70, 95% CI 1.07-12.84; p = 0.03). Post-procedural mortality was not significantly increased (Peto OR 0.50, 95% CI 0.12-2.09; p = 0.33). Overall mortality did not differ significantly between groups (Peto OR 1.57, 95% CI 0.61-4.04; p = 0.35). Conclusions: In randomized trials, the mortality signal associated with EBV appears confined to the peri-procedural period and is largely driven by pneumothorax-related deaths. No excess mortality was observed beyond 90 days. These findings may inform patient counseling, peri-procedural management, and future trials with survival endpoints.
Contributed Indexing:	Keywords: Endobronchial valves; bronchoscopic lung volume reduction; emphysema; mortality; pneumothorax
Entry Date(s):	Date Created: 20260725 Date Completed: 20260901 Latest Revision: 20260909
Update Code:	20260910
DOI:	10.1080/17434440.2026.2710806
PMID:	42500855
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1745-2422
DOI:	10.1080/17434440.2026.2710806