RT Journal Article
SR Electronic
T1 First experiences of a regional lung center offering coil treatment for severe emphysema
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3729
VO 44
IS Suppl 58
A1 H. Jost Achenbach
A1 Mathias Juech
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3729.abstract
AB Background: Bronchoscopic treatment of severe emphysema with Coils (PneumRx Inc., USA) has been shown to improve exercise capacity, lung function, and quality of life in severe emphysema and is used in clinical practice across Germany. We are the first teaching hospital in eastern Germany to incorporate Coils into our routine practice, and report here on our first experiences.Methods: Patients with bilateral GOLD III/IV emphysema, hetero- or homogenous distribution, RV > 200% pred., TLC > 100% pred., CAT > 10 patients. We exclude patients with giant bullae, known PH (sPAP > 50 mmHg), recent exacerbations, prior LVR treatment, chronic steroid use, and DLCO < 20% pred. Baseline values for our first 20 treated patients: mean FEV1 28.6% pred., mean RV 260% pred. (range 197 - 432%), mean 6MWT 272m. 10 Coils were placed in each lobe. Average procedure time was 40 min. Follow-up is conducted approx. 3 and 12 months following treatment.Results: 14/20 (70%) completed bilateral treatment, with follow-up on 10/14 showing improvement in all parameters at 141 days (6MWT +45m, FEV1+2.6% pred., RV -23.5% pred., CAT -0.86). 10 patients with unilateral results at 110 days show similar change in all except 6MWD (+17.2m) which was significantly less than post bilateral treatment. A total of 4 treatment related events occurred in 34 procedures (11%). Transient procedural discomforts resolved about 1 week post treatment. We find coil treatment to be safe and effective in a broad but well selected group of patients with emphysema. The procedure is well tolerated and accepted by the patients.