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Original Research: COPD |

Bilateral Endoscopic Sealant Lung Volume Reduction Therapy for Advanced EmphysemaLung Sealant Volume Reduction Therapy

Mordechai R. Kramer, MD, FCCP; Yael Refaely, MD; Nimrod Maimon, MD; Dror Rosengarten, MD; Oren Fruchter, MD
Author and Funding Information

From the Pulmonary Institute Rabin Medical Center (Drs Kramer, Rosengarten, and Fruchter), Beilinson Hospital, Petah Tikva; and the Department of Thoracic Surgery (Dr Refaely), and the Department of Pulmonary Medicine (Dr Maimon), Soroka Medical Center, Be’er Sheeva, Israel.

Correspondence to: Mordechai Kramer, MD, FCCP, Pulmonary Institute and Lung Transplantation Program, Rabin Medical Center, Beilinson Hospital, Petah Tikva 49100, Israel; e-mail: kramerm@netvision.net.il


Funding/Support: This study was supported by Aeris Therapeutics, Woburn, MA.

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


Chest. 2012;142(5):1111-1117. doi:10.1378/chest.12-0421
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Background:  A clinical study was performed to assess the safety and efficacy of bilateral AeriSeal Emphysematous Lung Sealant System (ELS) treatment in patients with advanced emphysema out to 1 year.

Methods:  Twenty patients received treatment at four subsegments, two in each upper lobe. Ten had upper lobe disease, and 10 had homogeneous disease. Treatments were administered under moderate sedation. Efficacy was assessed at 3, 6, and 12 months.

Results:  Procedure times were short (15.2 ± 9.6 min), and hospital length of stay averaged 1.1 days. The study was successful in reaching its primary end point of a reduction at 3 months in upper lobe lung volume assessed by quantitative CT scan analysis (−895 ± 484 mL, P < .001). Treatment was associated with improvements in spirometry (ΔFEV1 at 6 months = 31.2% ± 36.6%, 12 months = 25.0% ± 33.4%), gas trapping (Δresidual volume/total lung capacity at 6 months = −7.2% ± 12.7%, 12 months = −10.9% ± 14.0%), diffusing capacity of lung for carbon monoxide (6 months = 12.7% ± 16.4%, 12 months = 12.3% ± 21.1%), symptom scores (ΔMedical Research Council dyspnea score at 6 months = median 0, range −2 to 1, 12 months = median −1, range −3 to 0), and health-related quality of life (ΔSt. George Respiratory Questionnaire at 6 months = −8.0 ± 17.2 U, 12 months = −7.0 ± 15.8 U). There was one serious procedural complication and seven all-cause significant respiratory adverse events over 17 patient-years of follow-up.

Conclusions:  Bilateral ELS treatment administered under conscious sedation in patients with advanced emphysema is associated with short procedure time and length of hospital stay and produces physiologic and functional improvement out to 1 year.

Trial registration:  ClinicalTrials.gov; No.: NCT01181466; URL: www.clinicaltrials.gov

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