Mid-term follow-up data after endoscopic lung volume reduction with nitinol coils in patients with very severe emphysema

Abstract

Background: Bilateral bronchoscopic lung volume reduction with nitinol coils (PneumRx Inc., USA) in severe emphysema has been shown to improve exercise capacity, lung function, and quality of life. We present mid-term follow-up (f/u) data from 30 bilaterally treated patients. Methods: 30 patients with COPD GOLD III/IV, category D and heterogenous or homogenous emphysema (mean RV 253±54%, mean FEV1 29,5±5,7%, mean 6MWD 299±108m, mean CAT 24,7±7 pts.) underwent bilateral coil treatment. F/u including lung function, exercise capacity, quality of life and adverse events was conducted at several points of time from 24 to 577 days post-treatment. Results: Mean f/u time so far was 241±148 days. Compared to baseline patients showed an improvement in all measured parameters (mean RV -491±853 ml, mean FEV1+31±204 ml, mean 6MWD +26±82m, mean CAT score -4,3±7 pts.). In about 10% of patients transient procedural discomforts (e.g. mild hemoptysis) occurred, usually within the first days following treatment and resolving spontaneously. Updated f/u data will be presented at the ERS congress. Conclusions: Our data confirm that coil treatment is a safe and effective add-on therapy for patients with severe COPD and emphysema. In accordance with larger studies we could demonstrate improvements in exercise capacity, lung function, and quality of life in mid-term f/u. RV reduction was statistically the most significant parameter, reflecting lung volume reduction via tissue re-tensioning concept of coil treatment.