Bronchoscopic lung volume reduction with a dedicated coil: a clinical pilot study

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Medical Devices

Background:

• Lung volume reduction surgery (LVRS) aims to alleviate symptoms in emphysema patients by reducing hyperinflation.
• Existing endoscopic LVRS methods often face limitations due to collateral ventilation (CV).
• This study introduces a novel endoscopic approach designed to bypass the challenges posed by CV.

Purpose of the Study:

• To evaluate the safety and feasibility of a new coil-based endoscopic lung volume reduction (ELVR) procedure.
• To assess the potential of this ELVR technique in patients with severe emphysema, irrespective of collateral ventilation.
• To explore preliminary efficacy outcomes of the novel ELVR approach.

Main Methods:

• Eleven patients with severe emphysema underwent 21 coil-placement procedures under general anesthesia.
• Inclusion/exclusion criteria mirrored the National Emphysema Treatment Trial (NETT), allowing for both homogenous and heterogeneous disease patterns.
• The primary endpoints focused on safety and feasibility, with secondary endpoints assessing efficacy.

Main Results:

• All procedures were well-tolerated, with an average duration of 45 minutes and placement of approximately 5 coils per procedure.
• Over a 7-11 month follow-up, 33 adverse events were reported, none of which were severe; no pneumothorax occurred.
• Preliminary findings suggest greater efficacy in patients with heterogeneous emphysema compared to homogenous disease.

Conclusions:

• Endoscopic lung volume reduction utilizing coils demonstrates a favorable safety and feasibility profile.
• The coil-based ELVR technique presents a viable option for managing severe emphysema.
• Further clinical investigations are warranted to fully establish the efficacy of this innovative treatment.