Evaluation of bronchoscopic lung volume reduction coil treatment results in patients with severe emphysema. (2nd October 2015)

• Record Type: Journal Article
• Authors: Gulsen, Askin; Sever, Fidan; Girgin, Pelin; Tamci, Necdet Batuhan; Yilmaz, Hatice
• Is Part Of: Clinical respiratory journal. Volume 11:Number 5(2017)
• Page Start: 585
• Page End: 592
• Publication Date: 2015-10-02
• Subjects: bronchoscopy – chronic obstructive lung disease – coil – emphysema – lung volume reduction; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.12387
• Languages: English
• ISSNs: 1752-6981

Abstract

Abstract: Introduction: Bronchoscopic lung volume reduction coil (BLVR‐C) implantation is an alternative therapeutic approach that can be applied together with medical treatment for patients with severe emphysema. BLVR‐C is both easier and safer in terms of complications than volume reduction surgery. This study aimed to evaluate medium‐term outcomes following BLVR‐C treatment. Methods: Forty patients who underwent BLVR‐C between September 2013 and March 2014 were reviewed retrospectively. We compared changes between the baseline and 6‐month post‐procedural results with respect to pulmonary function tests, a 6‐min walk test (6MWT), chronic obstructive pulmonary disease (COPD) assessment test (CAT), St. George's Respiratory Questionnaire (SGRQ), and pulmonary artery pressure (PAP) and arterial blood gas analyses. Secondary outcomes included procedure‐related and follow‐up complications. Results: An average of 9.5 (range: 5–11) coils were placed per lung in an average procedural duration of 20.8 ± 7.0 min (range: 9–45) min. Six months after BLVR‐C treatment, significant improvements were observed in patients' pulmonary function tests and quality of life. Changes were observed in the forced exhalation volume in 1 s (+150 mL), residual volume (−14.5%), 6MWT (+48 m), SGRQ (−10.5) and CAT Score (−7.5). Changes in the PAP and partial pressure of carbon dioxide values were not significant, and pneumothorax did not occur. In a 6‐month follow‐up, 11 cases of COPD exacerbation (41.4%), 7 cases of pneumonia (16.9%) and 1 death (2%) occurred. Treatment in 1 case was postponed because of hypotension and bradycardia during the process. Conclusion: BLVR‐C treatment appears to be effective over the medium‐term and safe for patients with severe emphysema.