0
Original Research: COPD |

Bronchoscopic Lung Volume Reduction for End-Stage Emphysema*: Report on the First 98 Patients

Innes Y. P. Wan, MBChB; Tudor P. Toma, MD; Duncan M. Geddes, MD; Greg Snell, MD; Trevor Williams, MD; Federico Venuta, MD, FCCP; Anthony P. C. Yim, MD, FCCP
Author and Funding Information

*From the Division of Cardiothoracic Surgery (Drs. Wan and Yim), The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China; Department of Respiratory Medicine (Drs. Toma and Geddes), Royal Brompton Hospital, London, UK; Department of Respiratory Medicine (Drs. Snell and Williams), Alfred Hospital, Melbourne, Australia; and Cattedra di Chirugia Toracica (Dr. Venuta), University of Rome La Sapienza, Rome, Italy.

Correspondence to: Anthony P. C. Yim, MD, FCCP, Professor and Chief of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China; e-mail: yimap@cuhk.edu.hk



Chest. 2006;129(3):518-526. doi:10.1378/chest.129.3.518
Text Size: A A A
Published online

Objectives: To report the first multicenter experience on the treatment of end-stage emphysema using an endobronchial valve (EBV) [Emphasys EBV; Emphasys Medical; Redwood City, CA].

Design: Retrospective analysis from prospective multicenter registry.

Patients and interventions: This is a study of the use of EBVs in the treatment of end-stage emphysema at nine centers in seven countries. Ninety-eight patients with mean FEV1 of 0.9 ± 0.3 L (30.1 ± 10.7% of predicted) [± SD] and residual volume (RV) of 5.1 ± 1.3 L (244.3 ± 0.3% of predicted) were treated over a period of 20 months. Spirometry, plethysmography, and diffusing capacity of the lung for carbon monoxide (Dlco) and exercise tolerance testing were performed at 30 days and 90 days after the procedure.

Results: RV decreased by 4.9 ± 17.4% (p = 0.025), FEV1 increased by 10.7 ± 26.2% (p = 0.007), FVC increased by 9.0 ± 23.9% (p = 0.024), and 6-min walk distance increased by 23.0 + 55.3% (p = 0.001). There was a trend toward improvement in Dlco, but this did not reach statistical significance (17.2 ± 52.0%, p = 0.063). Patients treated unilaterally showed a trend toward greater improvement than those treated bilaterally. A similar trend toward improvement was observed in patients who had one entire lobe treated compared to those with just one or two bronchopulmonary segments treated. Eight patients (8.2%) had serious complications in the first 90 days, including one death (1.0%).

Conclusion: This multicenter analysis confirms that improvement in pulmonary function and exercise tolerance can be achieved in emphysematous patients using EBVs. Future efforts should be directed to determining how to select those patients who would benefit most from this procedure and the best endobronchial treatment strategy.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543