Bronchoscopic lung volume reduction with a dedicated coil: a clinical pilot study.
BACKGROUND
Lung volume reduction aims to improve symptoms by reducing hyperinflation. Endoscopic approaches so far have generally been hampered in their efficacy by collateral ventilation (CV). We sought to determine the safety and feasibility of a new endoscopic lung volume reduction approach independent of the effects of CV.


METHODS
Patients with severe emphysema were eligible. Inclusion and exclusion criteria were modeled after the National Emphysema Treatment Trial (NETT) study. Homogenous and heterogeneous disease was allowed. Treatment consisted of the placement of coils into the parenchyma of the most diseased area with the intent of achieving parenchymal compression. Primary endpoints were safety and feasibility assessments. Secondary endpoints were efficacy outcomes.


RESULTS
Eleven patients underwent 21 procedures. Procedures were performed under general anesthesia and lasted 45+/-15 minutes and per procedure 4.9+/-0.6 coils were placed. All procedures were well tolerated. The total follow-up time was 7-11 months and in that time 33 adverse events were reported, none of them severe. No pneumothorax occurred. Efficacy seemed better in heterogeneous rather than homogenous disease.


CONCLUSIONS
Endoscopic lung volume reduction with coils is safe and feasible. Further studies of the efficacy are indicated.
Department of Pulmonology, Thoraxklinik Heidelberg, Germany.
Felix J F
FJ
Herth
Ralf
R
Eberhard
Daniela
D
Gompelmann
Dirk-Jan
DJ
Slebos
Armin
A
Ernst
D000368:Aged; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D004646:Emphysema / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome