Investor Information
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Bronchoscopic Management for Persistent Air Leaks
Minimally Invasive Treatment

Persistent air leak (PAL) within the lung is defined to extend beyond 5-7 days leading to prolonged chest drainage and hospital stay, and may increase morbidity.1-6

Zephyr® Valves, placed minimally invasively via a bronchoscope, treat persistent air leaks effectively and may result in a shorter length of hospital stay compared with standard chest drain management alone.7
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Lungs

What is a Persistent Air Leak?

An air leak within the lung is defined as air escaping from the lung into the pleural cavity, resulting in a pneumothorax. It is caused by an alveolar-pleural fistula; a communication between the alveoli and the pleural space. This also can occur between a bronchus and the pleura, a broncho-pleural fistula.

If air continues to pass through the fistula and into the pleural space, it can become large enough to inhibit lung expansion, and require treatment with a chest drain.1
A persistent air leak is defined as one which lasts for greater than 5 to 7 days.

How Do Zephyr Valves Treat Persistent Air Leaks?

One Way Silcone

Zephyr Valves are placed via a bronchoscope under either conscious sedation or general anesthesia.8

Zephyr Valves placed in the lobar or subsegmental bronchi block the flow of air to the leak, allowing the pneumothorax to resolve. Fiorelli A et al. demonstrated resolution of 88% of the air leaks within 5.0 +/- 1.7 days.

Clinical Evidence

The success of Zephyr Valves in managing persistent air leaks has been reported in multiple case series and case reports.

In a retrospective multicenter study evaluating Zephyr Valves for persistent air leak due to alveolar-pleural fistula, 88% of patients achieved complete air-leak resolution, with a further 9% demonstrating reduction in leak severity7.
Valves were removed in 82% of patients after a mean of 134 ± 83 days, with no reported complications or recurrence of air leak following removal7.
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Discover all case studies and learn about the management of Persistent Air Leaks with Zephyr Valves in our brochure.
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The Procedure

Key Outcomes

Effective Management of Persistent Air Leaks7

key (1)

References
1 DuganK et al. (2017) Management of Persistent Air Leaks CHEST 2017; 152(2):417-423
2 Sirbu, H, Busch, T, Aleksic, I, Schreiner, W, Oster, O, & Dalichau, H. Bronchopleural fistula in the surgery of non-small cell lung cancer: incidence, risk factors, and management.
Ann Thorac Cardiovasc Surg, 2001; 7(6), 330–336.
3 Liang, S, et al. Quantifying the incidence and impact of postoperative prolonged alveolar air leak after pulmonary resection. J Thorac Cardiovasc Surg, 2013; 145(4), 948–954.
4 Bardell, T, & Petsikas, D. What keeps postpulmonary resection patients in hospital?. Can Respir J, 2003; 10(2), 86-89.
5 Varela, Gonzalo, et al. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg, 2005; 27(2), 329–333.
6 Irshad, Kashif, et al. Causes of increased length of hospitalization on a general thoracic surgery service: a prospective obser-vational study. Can J Surg, 2002; 45(4), 264.
7 Fiorelli A, D’Andrilli A, Cascone R, Occhiati L, Anile M, Diso D, Cassiano F, Poggi C,Ibrahim M, Cusumano G, Terminella A, Failla G, La Sala A, Bezzi M, Innocenti M, Torricelli E, Venuta F, Rendina EA, Vicidomini G, Santini M, Andreetti C. Unidi-rectional endobronchial valves for management of persistent air-leaks: results of a multicenter study. J Thorac Dis 2018;10(11):6158-6167. doi: 10.21037/ jtd.2018.10.61

8 Pulmonx Corp. Zephyr® Endobronchial Valve System Clinical Evaluation Report. Document 631-0016, Revision J. Redwood City, CA: Pulmonx Corporation; 2025; Section 3.7 (Intended Users).
9 Mahajan AK, Doeing DC, Hogarth DK. Isolation of persistent air leaks and placement of intrabronchial valves. J Thorac Cardiovasc Surg. 2013;145:626-630
10 Ficial, B.; Whebell, S.; Taylor, D.; Fernández-Garda, R.; Okiror, L.; Meadows, C.I.S. Bronchoscopic Endobronchial Valve Therapy for Persistent Air Leaks in COVID-19 Patients Requiring Veno-Venous Extracorporeal Membrane Oxygenation. J. Clin. Med. 2023, 12, 1348.

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