Does Bronchoscopic Lung Volume Reduction Reduce Mortality in Patients with Severe Emphysema?

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Devices

Background:

• Severe emphysema, a component of chronic obstructive pulmonary disease (COPD), significantly impacts patient mortality.
• Bronchoscopic lung volume reduction (BLVR) presents a minimally invasive therapeutic option for selected COPD patients.
• Endobronchial valves (EBV) and coils are key technologies employed in BLVR procedures.

Purpose of the Study:

• To compare the 12-month mortality rates between patients with severe emphysema undergoing BLVR (EBV or coil treatment) and those receiving standard of care (SoC).
• To evaluate the efficacy of BLVR in reducing mortality in advanced COPD patients with an emphysema phenotype.

Main Methods:

• A case-control study was conducted evaluating medical data from January 2010 to January 2017.
• 124 patients with advanced COPD-emphysema phenotype meeting BLVR criteria were analyzed, including 73 treated with BLVR (43 EBV, 30 coil) and 51 on SoC.
• 12-month follow-up data on mortality was the primary outcome measure.

Main Results:

• Overall 12-month mortality was 16.1% (20 patients), with 9.6% in the BLVR group and 25.5% in the SoC group.
• Mortality was significantly lower in the BLVR group compared to the SoC group at 12 months.
• No significant difference in early period mortality was observed between the BLVR and SoC groups.

Conclusions:

• Bronchoscopic lung volume reduction (BLVR) treatment, utilizing endobronchial valves or coils, significantly reduces 12-month mortality in patients with advanced emphysema.
• BLVR is a valuable therapeutic strategy for improving survival in severe emphysema patients.
• Keywords: Emphysema, Mortality, Endobronchial valve, Coil, Bronchoscopic lung volume reduction.