Lung volume reduction coil treatment for patients with severe emphysema: a European multicentre trial
Publication year
2014Source
Thorax, 69, (2014), pp. 980-986ISSN
Publication type
Article / Letter to editor
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Organization
Medical Imaging
Journal title
Thorax
Volume
vol. 69
Page start
p. 980
Page end
p. 986
Subject
Radboudumc 5: Inflammatory diseases RIHS: Radboud Institute for Health SciencesAbstract
The lung volume reduction ({LVR}) coil is a minimally invasive bronchoscopic nitinol device designed to reduce hyperinflation and improve elastic recoil in severe emphysema. We investigated the feasibility, safety and efficacy of {LVR} coil treatment in a prospective multicentre cohort trial in patients with severe emphysema.Patients were treated in 11 centres. Safety was evaluated by recording all adverse events, efficacy by the St George's Respiratory Questionnaire ({SGRQ}) as primary endpoint, and pulmonary function testing, modified Medical Research Council dyspnoea score ({mMRC}) and 6-min walk distance ({6MWD}) up to 12 months after the final treatment.Sixty patients (60.9 ± 7.5 years, forced expiratory volume in 1 s ({FEV1}) 30.2 ± 6.3\% pred) were bronchoscopically treated with coils (55 bilateral, 5 unilateral), with a median of 10 (range 5-15) coils per lobe. Within 30 days post-treatment, seven chronic obstructive pulmonary disease exacerbations (6.1\%), six pneumonias (5.2\%), four pneumothoraces (3.5\%) and one haemoptysis (0.9\%) occurred as serious adverse events. At 6 and 12 months, respectively, {ΔSGRQ} was -12.1±12.9 and -11.1±13.3 points, {Δ6MWD} was +29.7±74.1 m and +51.4±76 m, {ΔFEV1} was +0.11±0.20 {L} and +0.11±0.30 {L}, and {ΔRV} (residual volume) was -0.65±0.90 {L} and -0.71±0.81 {L} (all p<0.01). Post hoc analyses showed significant responses for {SGRQ}, {6MWD} and {RV} in patients with both heterogeneous and homogeneous emphysema.{LVR} coil treatment results in significant clinical improvements in patients with severe emphysema, with a good safety profile and sustained results for up to 1 year.{NCT01328899.}
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- Faculty of Medical Sciences [90373]
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