Introduction
Persistent air leak (PAL) is the communication between alveolar and pleural space for more
than 5 days. It occurs in patients with spontaneous pneumothorax secondary to underlying
pathology. The standard treatment is surgery, but endoscopic treatments have been developed.
Material and methods
Retrospective observational study of a cohort of patients with a diagnosis of PAL treated with
endobronchial valves (EBV) in a tertiary hospital between 2016 and 2022.
Results
Fifteen patients were included. 66 % male, mean age 67. PAL occurred in 6 due to spontaneous pneumothorax, in 4 after surgery, while 5 had fistulisation secondary to an infectious process (Image 1). One patient presented with PAL due to fistulisation following SARS-CoV-2 infection requiring extracorporeal membrane oxygenation which was removed after valve placement.
The leak was located in the left upper lobe in 7 patients (46%), 9 (60%) required one valve
placement, 4 (26%) required 2 and 2 (13%) required 3 valves. 11 (73.3%) had resolution of PAL while 4 (26.7%) could not have their chest drain removed due to persistent PAL and required reoperation, wich was successful in one of them.

The median of days for valve removal after placement was 31.5. One patient continued with the valves due to a positive response with the volume reduction caused. 3 of the patients (20%) had a respiratory infection within 7 days of valve placement resolved with antibiotic without valve removal and 2
(13.3%) had valve displacement.

Conclusions
In our population 73.3% resolved the air leak after EBV placement. Complications were as
expected according to the literature, all minor and resolved with outpatient treatment, with a mortality rate of 0%.