0
Original Research |

Bronchoscopic Lung Volume Reduction Coil Treatment of Patients With Severe Heterogeneous EmphysemaLung Volume Reduction Coil Treatment of Emphysema

Dirk-Jan Slebos, MD, PhD; Karin Klooster, BSc; Armin Ernst, MD, PhD, FCCP; Felix J. F. Herth, MD, PhD, FCCP; Huib A. M. Kerstjens, MD, PhD
Author and Funding Information

From the Department of Pulmonary Diseases (Drs Slebos and Kerstjens and Ms Klooster), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Pulmonary, Critical Care and Sleep Medicine (Dr Ernst), St. Elizabeth Medical Center/Tufts University School of Medicine, Boston, MA; and Pneumology and Critical Care Medicine (Dr Herth), Thoraxklinik, Heidelberg, Germany.

Correspondence to: Dirk-Jan Slebos, MD, PhD, Department of Pulmonary Diseases, University Medical Center Groningen, PO Box 30001, AA11, 9700 RB Groningen, The Netherlands; e-mail: d.j.slebos@long.umcg.nl


For editorial comment see page 552

Funding/Support: This study was sponsored by PneumRx, Inc, Mountain View, CA.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(3):574-582. doi:10.1378/chest.11-0730
Text Size: A A A
Published online

Background:  The lung volume reduction coil (LVR-coil), a new experimental device to achieve lung volume reduction by bronchoscopy in patients with severe emphysema, works in a manner unaffected by collateral airflow. We investigated the safety and efficacy of LVR-coil treatment in patients with heterogeneous emphysema.

Methods:  In this prospective cohort pilot study, patients were treated bronchoscopically with Nitinol LVR-coils under fluoroscopic guidance in either one procedure or two sequential procedures. Follow-up tests included the St. George Respiratory Questionnaire (SGRQ), pulmonary function testing, and the 6-min walk test (6MWT).

Results:  Twenty-eight LVR-coil procedures were performed in 16 patients (baseline FEV1, 28% [± 7.6%] predicted). Four patients were treated in one lung, and 12 patients were treated in both lungs. A median of 10 (5-12) coils was placed per lung in 36.5 (20-60) min. Adverse events (AEs) rated as possibly related to either the device or the procedure < 30 days after treatment were pneumothorax (n ± 1), pneumonia (n ± 2), COPD exacerbation (n ± 6), chest pain (n ± 4), and mild (<, 5 mL) hemoptysis (n ± 21). From 30 days to 6 months, the AEs that occurred were pneumonia (n ± 3) and COPD exacerbation (n ± 14). All events resolved with standard care. Six months after LVR-coil treatment, there were significant improvements in SGRQ (×14.9 points [± 12.1 points, with 11 patients improving by . 4 points]), FEV1 (−14.9% ± 17.0%), FVC (−13.4% ± 12.9%), residual volume (×11.4% ± 9.0%), and 6MWT (−84.4 ± 73.4 m), all P < .005.

Conclusions:  LVR-coil treatment is a promising technique for the treatment of patients with severe heterogeneous emphysema. The treatment is technically feasible and results in significant improvements in pulmonary function, exercise capacity, and quality of life, with an acceptable safety profile.

Trial registry:  ClinicalTrials.gov; No.:NCT01220908; URL: www.clinicaltrials.gov

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