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Two-Year Follow-up in Patients Treated With Emphysematous Lung Sealant for Advanced EmphysemaTwo-year Responses to Bronchoscopic Sealants

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

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

Correspondence to: Mordechai R. Kramer, MD, FCCP, Pulmonary Institute and Lung Transplantation Program, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel 49100; e-mail: kremerm@clalit.org.il


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


Chest. 2013;144(5):1677-1680. doi:10.1378/chest.13-0446
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Endoscopic lung volume-reduction therapy for emphysema has been associated with therapeutic responses smaller in magnitude and less durable than surgical volume reduction (LVRS). Bronchoscopic emphysematous lung sealant (ELS) therapy has been shown to produce improvements in pulmonary function similar to surgery at 1 year. This case series summarizes safety and efficacy data of all patients from the initial ELS study out to 2 years. Between 1 and 2 years, there were three all-cause adverse events requiring hospitalization. One patient went on to successful lung transplant. Improvements relative to baseline in spirometry (change in FEV1: + 14.3 ± 33.1%; change in FVC: + 5.8 ± 23.2%) and diffusing capacity (change in diffusing capacity of the lung for carbon monoxide: + 10.6 ± 20.6%) were observed at 2 years. An exponential model fit to FEV1 data at 6, 12, 18, and 24 months predicted improvements from a baseline of > 5% out to 4.1 years, similar to what has been reported following surgery. This report confirms long-term safety and efficacy following ELS therapy in advanced emphysema. Studies in a larger cohort are needed to define the role of ELS therapy in the treatment algorithm of patients with this condition.

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