Bronchoscopic lung volume reduction using coil therapy: complications and management

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Medical Devices

Background:

• Bronchoscopic lung volume reduction (BLVR) offers a nonsurgical treatment for end-stage emphysema.
• The BLVR coil procedure specifically targets patients with homogeneous and heterogeneous emphysema and severe airflow limitation (FEV1 15-45%).

Purpose of the Study:

• To review the efficacy and safety of the BLVR coil procedure.
• To identify potential complications and suggest strategies for their prevention and management.

Main Methods:

• Literature review of studies on BLVR coil procedures.
• Analysis of reported complications and patient outcomes.
• Evaluation of pre- and post-procedure management strategies.

Main Results:

• The BLVR coil procedure effectively reduces hyperinflation, improving lung function, quality of life, and exercise capacity.
• Common complications include COPD exacerbation, chest pain, bleeding, pneumonia, pneumothorax, and respiratory failure.
• Rare but serious complications like aspergillus cavitation and bronchopleural fistula can occur, necessitating prompt diagnosis and treatment.

Conclusions:

• Pre-procedure premedication and post-procedure macrolide treatment may mitigate complications.
• Utilizing newer supraglottic devices could reduce intubation-related risks.
• Further research is needed to identify risk factors, establish preventive protocols, and reach a consensus on routine care.