Minimally invasive persistent air leak management

Persistent air leak (PAL) management is a complex clinical entity with a variety of underlying etiologies and treatment options. Imprecise use of nomenclature associated with this condition has confounded the situation. Guidelines on the subject are antiquated and do not include modern therapeutic modalities. Bronchoscopic options, namely endobronchial valves, have revolutionized PAL treatment in patients who are poor surgical candidates. The paucity of high-quality data has prohibited revision of older guidelines. Development of evidence-based treatment algorithms is necessary to advance the quality and consistency of care for this serious clinical problem.