Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema

Endoscopic endobronchial valve lung volume reduction in the management of severe emphysema reduces volume inflation in the most severely affected areas, with the hope of clinical improvement. We report the case of a patient who presented with late progressive respiratory deterioration following endo...

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Main Authors: Jacques Dzuko Kamga, Christophe Gut Gobert, Thomas Egenod, Nicolas Guibert, Pierre-Yves Le Roux
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1572900/full
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author Jacques Dzuko Kamga
Christophe Gut Gobert
Christophe Gut Gobert
Thomas Egenod
Nicolas Guibert
Pierre-Yves Le Roux
Pierre-Yves Le Roux
author_facet Jacques Dzuko Kamga
Christophe Gut Gobert
Christophe Gut Gobert
Thomas Egenod
Nicolas Guibert
Pierre-Yves Le Roux
Pierre-Yves Le Roux
author_sort Jacques Dzuko Kamga
collection DOAJ
description Endoscopic endobronchial valve lung volume reduction in the management of severe emphysema reduces volume inflation in the most severely affected areas, with the hope of clinical improvement. We report the case of a patient who presented with late progressive respiratory deterioration following endoscopic endobronchial valve lung volume reduction. Ventilation/perfusion (V/Q)-SPECT/CT showed unexpectedly high perfusion in the atelectasis of the treated lobes, reflecting a paradoxical intrapulmonary shunt. This paradoxical complication of endobronchial valve treatment for severe emphysema is rare and highlights the potential usefulness of performing V/Q-SPECT/CT imaging in patients presenting with respiratory deterioration following endoscopic lung volume reduction.
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publishDate 2025-05-01
publisher Frontiers Media S.A.
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spelling doaj-art-e44b481edb0549af87da411408ca69502025-08-20T01:49:58ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15729001572900Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysemaJacques Dzuko Kamga0Christophe Gut Gobert1Christophe Gut Gobert2Thomas Egenod3Nicolas Guibert4Pierre-Yves Le Roux5Pierre-Yves Le Roux6Department of Nuclear Medicine, Brest University Hospital, Brest, FranceDepartment of Pneumology, Brest University Hospital, Brest, FranceGETBO, INSERM, UMR1304, Université de Bretagne Occidentale, Brest, FranceDepartment of Pneumology, Limoges University Hospital, Limoges, FranceDepartment of Pneumology, Toulouse University Hospital, Toulouse, FranceDepartment of Nuclear Medicine, Brest University Hospital, Brest, FranceGETBO, INSERM, UMR1304, Université de Bretagne Occidentale, Brest, FranceEndoscopic endobronchial valve lung volume reduction in the management of severe emphysema reduces volume inflation in the most severely affected areas, with the hope of clinical improvement. We report the case of a patient who presented with late progressive respiratory deterioration following endoscopic endobronchial valve lung volume reduction. Ventilation/perfusion (V/Q)-SPECT/CT showed unexpectedly high perfusion in the atelectasis of the treated lobes, reflecting a paradoxical intrapulmonary shunt. This paradoxical complication of endobronchial valve treatment for severe emphysema is rare and highlights the potential usefulness of performing V/Q-SPECT/CT imaging in patients presenting with respiratory deterioration following endoscopic lung volume reduction.https://www.frontiersin.org/articles/10.3389/fmed.2025.1572900/fullendo-bronchial valvesendoscopic lung volume reduction (ELVR)emphysemaventilation-perfusion SPECT–CTlung scintigraphypulmonary shunt
spellingShingle Jacques Dzuko Kamga
Christophe Gut Gobert
Christophe Gut Gobert
Thomas Egenod
Nicolas Guibert
Pierre-Yves Le Roux
Pierre-Yves Le Roux
Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema
Frontiers in Medicine
endo-bronchial valves
endoscopic lung volume reduction (ELVR)
emphysema
ventilation-perfusion SPECT–CT
lung scintigraphy
pulmonary shunt
title Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema
title_full Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema
title_fullStr Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema
title_full_unstemmed Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema
title_short Case Report: Late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema
title_sort case report late paradoxical intrapulmonary shunt after endoscopic lung volume reduction with endobronchial valves for severe emphysema
topic endo-bronchial valves
endoscopic lung volume reduction (ELVR)
emphysema
ventilation-perfusion SPECT–CT
lung scintigraphy
pulmonary shunt
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1572900/full
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