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Long‐term follow‐up after bronchoscopic lung volume reduction treatment with coils in patients with severe emphysema
Author(s) -
Hartman Jorine E.,
Klooster Karin,
Gortzak Kiki,
Hacken Nick H.T.,
Slebos DirkJan
Publication year - 2015
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12435
Subject(s) - medicine , pulmonary function testing , adverse effect , electromagnetic coil , lung volumes , lung volume reduction , surgery , lung , radiology , electrical engineering , engineering
Background and objective Bronchoscopic 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. Methods Thirty‐eight patients with severe emphysema (median age is 59 years, forced expiratory volume in 1 s 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 (6 MWD ) and questionnaires. Results Thirty‐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 6 MWD minimal important difference, and 59% for the S t G eorge's R espiratory Q uestionnaire ( SGRQ ) minimal important difference. Conclusions Follow‐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 6 MWD , SGRQ and mMRC . Clinical trial registration NCT01220908 and NCT01328899 registered at ClinicalTrials.gov.