Introduction: Embolisation is established to treat major hemoptysis mainly in patients with CF, bronchiectasis or AV malformation but less successful for malignancy. Endobronchial valve placement is mainly used for BLVR. Valve insertion for major hemoptysis has only been described in 3 cases in the literature.

Methods: We describe the clinical course of patients with major hemoptysis treated with bronchoscopic valve implantation at our centre from 2015 to 2022

Results: 32 patients were treated with valve implantation via flexible bronchoscopy under nurse administered sedation. 2 patients received valves on 2 episodes, 1 with a second episode after a few days and a pregnant patient with another episode 34 months later. 22% patients were anticoagulated. 16 patients suffered from malignancy, 7 from COPD/chronic bronchitis, 4 from infection, 4 from vascular disease and 1 from iatrogenic injury respectively. One valve was placed in 90% of all cases. Due to uncontrollable bleeding following embolization a patient with a collagen defect had unsuccessfully received 12 valves followed by bilobectomy and eventually lung transplantation. A pregnant patient with AV malformation continued bleeding while valve and embolization failed and was finally treated with lobectomy. The procedure was successful in 91% of all cases. 30day mortality was 6% (not associated with hemoptysis). Overall 12-months-survival was 90.7%. In half of the patients valves were removed within 12 months mainly in cases without malignancy. There were no secondary valve associated complications during the first year.

Conclusion: Valve implantation via flexible bronchoscopy is a safe treatment option for selected patients with major hemoptysis.