Abstract
Background: Treatment of severe emphysema with bronchoscopically-placed Coils has been shown to improve exercise capacity, lung function, and QOL in severe emphysema patients and is used in routine practice in Germany. We report on the combined experience of 3 centers in northern Germany using a similar patient selection and treatment algorithm.
Methods: We select severe patients with heterogenous or homogenous emphysema, RV >200% pred., TLC > 100% pred. Exclusion criteria based on previous clinical studies. Baseline values were 64 years of age, mean FEV1 24.6% pred., mean RV 276% pred. (range 164 – 448%), and mean 6MWD 203m) and did not differ between unilaterally- and bilaterally-treated groups except for 6MWD (170m and 234m, respectively). Ten Coils were placed in each lobe with 33 patients completing unilateral treatment and 32 patients completing bilateral treatment, to date.
Results: There was (see Tabl.1) significantly improved outcomes in the bilateral group vs. the unilateral group at 6 and 12 months post-baseline. However, there are few unilateral observations as the majority of patients complete the second treatment. Complications included COPD exacerbation (N=6, 3,9%), pneumonia (N=2, 1,3%), and hemoptysis (N=3, 2%), with one case of respiratory failure. Bilateral coil is a save procedure and treatment offers significant clinical improvements for a broad group of emphysema patients in our practice with sustained improvements at one year.
- © 2014 ERS