Abstract
Background: Bronchoscopic lung volume reduction (BLVR) using biological agents is one of the new alternatives to lung volume reduction surgery.
Objectives: To evaluate efficacy and safety of biological BLVR using low cost agents including autologous blood and fibrin glue.
Methods: 8 male patients were enrolled and divided into two groups: group A in which autologous blood was used and group B fibrin glue was used. The agents were injected through a triple lumen balloon catheter via fiberoptic bronchoscope. Changes in high resolution CT (HRCT) volumetry, pulmonary function tests, symptoms, and exercise capacity were evaluated at 12-week post procedure as well as for complications.
Results: The mean (± SD) age was 57.75 ±10.62 years. In group A at 12-week post procedure there was significant improvement in the mean value of modified medical research council (mMRC) score, 6-min walk distance (6MWD), residual volume / total lung capacity (RV/TLC) ratio, forced expiratory volume in one second /forced vital capacity (FEV1/FVC) ratio, HRCT volumetry (p-value: 0.014, 0.014, 0.008, 0.008, 0.003 respectively). In group B at 12-week post procedure there was significant improvement in the mean value of FEV1/FVC ratio (p-value: 0.012).However, the improvement in the mean value of mMRC score, 6MWD, RV/TLC ratio, HRCT volumetry was not significant (p-value: 0.058, 0.075, 0.164, 0.402 respectively).All patients tolerated the procedure and were discharged 1 day later, except one in group B who developed exacerbation that was controlled by medical therapy.
Conclusion: These Preliminary results indicate that BLVR using low cost biological agents was safe, less invasive, less costly and effective in treating advanced emphysema.
- © 2014 ERS
