PT  - JOURNAL ARTICLE
AU  - G. Snell
AU  - F.J.F. Herth
AU  - P. Hopkins
AU  - K.M. Baker
AU  - C. Witt
AU  - M.H. Gotfried
AU  - A. Valipour
AU  - M. Wagner
AU  - F. Stanzel
AU  - J. Egan
AU  - S. Kesten
AU  - A. Ernst
TI  - Bronchoscopic thermal vapor ablation therapy in the management of heterogeneous emphysema
AID  - 10.1183/09031936.00092411
DP  - 2011 Jan 01
TA  - European Respiratory Journal
PG  - erj00924-2011
4099  - http://erj.ersjournals.com/content/early/2011/11/09/09031936.00092411.short
4100  - http://erj.ersjournals.com/content/early/2011/11/09/09031936.00092411.full
AB  - The need for a procedure less invasive than surgical lung volume reduction that can produce consistent improvements with reduced morbidity remains a medical goal in patients with emphysema. We sought to determine the effect of Bronchoscopic Thermal Vapor Ablation (BTVA) on lung volumes and outcomes in patients with emphysema.Forty-four patients with upper lobe predominant emphysema were treated unilaterally with BTVA. Entry criteria included: age 40–75 years, FEV1 15%–45% predicted, previous pulmonary rehabilitation and a Heterogeneity Index (tissue/air ratio of lower lobe/upper lobe) from HRCT≥1.2. Changes in FEV1, St. George's Respiratory Questionnaire(SGRQ), six-minute walk distance(6MWD), mMRC dyspnoea, and hyperinflation were measured at baseline, 3 and 6 months post-BTVA.At 6 months, mean±SE FEV1 improved by 141±26 mL(p<0.001), RV was reduced by 406±113 mL(p<0.0001). SGRQ total score improved by 14.0±2.4 units(p<0.001) with 73% improving by ≥4 units. Improvements were observed in 6MWD (46.5±10.6 m) and mMRC (0.9+0.2), (p<0.001 for both). Lower respiratory events (n=11) were the most common adverse event and occurred most often during the initial 30 days.BTVA therapy results in clinically relevant improvements in lung function, quality of life and exercise tolerance in upper lobe predominant emphysema.