title: Bronchoscopic Coil Treatment for Patients with Severe Emphysema: A Meta-Analysis.
abstract: BACKGROUND
  Bronchoscopic coil treatment has been shown to improve pulmonary function, exercise capacity, and quality of life in patients with severe emphysema.
  
  
  OBJECTIVE
  To perform a meta-analysis of the results of four independent European clinical trials investigating this coil therapy for emphysema.
  
  
  METHODS
  Data on all patients included in the four European clinical trials were analyzed for efficacy and safety outcomes.
  
  
  RESULTS
  A total of 2,536 coils were placed during 259 procedures in 140 patients. A total of 37 chronic obstructive pulmonary disease exacerbations and 27 pneumonias were recorded as serious adverse events up to 1 year after treatment. The pneumothorax rate was 6.4%. Both 6 and 12 months after treatment, significant (all p < 0.001) improvements were observed for: forced expiratory volume in 1 s [+0.08 liters (±0.19) and +0.08 liters (±0.21)], residual volume [RV; -510 ml (±850) and -430 ml (±720)], 6-min walking distance [6MWD; +44.1 m (±69.8) and +38.1 m (±71.9)], and St. George's Respiratory Questionnaire score [SGRQ; -9.5 points (±14.3) and -7.7 points (±14.2)]. No differences in any outcome measures were observed between heterogeneous and homogeneous emphysema patients. Only a high baseline RV was found to be an independent predictor of successful treatment.
  
  
  CONCLUSIONS
  Bronchoscopic coil treatment improves pulmonary function, 6MWD, and quality of life in patients with severe emphysema up to 1 year after treatment, independent of the distribution of the disease.
authors.affiliation: Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Dirk-Jan
authors.initials: DJ
authors.lastname: Slebos
authors.forename: Jorine E
authors.initials: JE
authors.lastname: Hartman
authors.forename: Karin
authors.initials: K
authors.lastname: Klooster
authors.forename: Stefan
authors.initials: S
authors.lastname: Blaas
authors.forename: Gaetan
authors.initials: G
authors.lastname: Deslee
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gesierich
authors.forename: Juergen
authors.initials: J
authors.lastname: Hetzel
authors.forename: Martin
authors.initials: M
authors.lastname: Hetzel
authors.forename: William
authors.initials: W
authors.lastname: McNulty
authors.forename: Samuel V
authors.initials: SV
authors.lastname: Kemp
authors.forename: Romain
authors.initials: R
authors.lastname: Kessler
authors.forename: Sylvie
authors.initials: S
authors.lastname: Leroy
authors.forename: Franz
authors.initials: F
authors.lastname: Stanzel
authors.forename: Christian
authors.initials: C
authors.lastname: Witt
authors.forename: Zaid
authors.initials: Z
authors.lastname: Zoumot
authors.forename: Felix J F
authors.initials: FJ
authors.lastname: Herth
authors.forename: Pallav L
authors.initials: PL
authors.lastname: Shah
mesh_terms: D000368:Aged; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000601:surgery; D011788:Quality of Life; D012129:Respiratory Function Tests; D016896:Treatment Outcome