Long-term follow-up after bronchoscopic lung volume reduction treatment with coils in patients with severe emphysema

Jorine E. Hartman*, Karin Klooster, Kiki Gortzak, Nick H. T. ten Hacken, Dirk-Jan Slebos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

57 Citations (Scopus)
69 Downloads (Pure)

Abstract

Background and objectiveBronchoscopic lung volume reduction coil (LVR-coil) treatment has been shown to be safe and clinically effective in patients with severe emphysema in the short term; however, long-term safety and effectiveness has not been evaluated. The aim of this study was to investigate the long-term safety and effectiveness of LVR-coil treatment in patients with severe emphysema.

MethodsThirty-eight patients with severe emphysema (median age is 59 years, forced expiratory volume in 1s is 27% predicted) who were treated in LVR-coil clinical trials were invited for a voluntary annual visit. Safety was evaluated by chest X-ray and recording of adverse events and by efficacy by pulmonary function testing, 6-min walk distance (6MWD) and questionnaires.

ResultsThirty-five patients visited the hospital 1 year, 27 patients 2 years and 22 patients 3 years following coil placement. No coil migrations were observed on X-rays. At 1-year follow-up, all clinical outcomes significantly improved compared with baseline. At 2 years, residual volume % pred, modified Medical Research Council (mMRC) and the SGRQ score were still significantly improved. At 3 years, a significant improvement in mMRC score remained, with 40% of the patients reaching the 6MWD minimal important difference, and 59% for the St George's Respiratory Questionnaire (SGRQ) minimal important difference.

ConclusionsFollow-up of the patients treated with LVR-coils in our pilot studies showed that the coil treatment is safe with no late pneumothoraces, coil migrations or unexpected adverse events. Clinical benefit gradually declines over time; at 3 years post-treatment, around 50% of the patients maintained improvement in 6MWD, SGRQ and mMRC.

Clinical trial registrationNCT01220908 and NCT01328899 registered at ClinicalTrials.gov.

Original languageEnglish
Pages (from-to)319-326
Number of pages8
JournalRespirology
Volume20
Issue number2
DOIs
Publication statusPublished - Feb-2015

Keywords

  • bronchoscopy and interventional technique
  • clinical respiratory medicine
  • coil
  • emphysema
  • long-term follow-up
  • OBSTRUCTIVE PULMONARY-DISEASE
  • MINIMAL IMPORTANT DIFFERENCE
  • TRIAL
  • STANDARDIZATION
  • SURGERY
  • COPD

Cite this