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

Abstract

Bronchoscopic lung volume reduction (BLVR) is a novel emphysema therapy. We evaluated long-term outcome in patients with heterogeneous emphysema undergoing BLVR with one-way valves.40 patients undergoing unilateral BLVR entered our study. Pre-operative mean forced expiratory volume in 1 s (FEV1) was 0.88 L?s -1 (23%), total lung capacity was 7.45 L (121%),intrathoracic gas volume was 6 L (174%), residual volume (RV) was 5.2 L (232%), and the 6-min walk test (6MWT) was 286 m. All patients required supplemental oxygen; the Medical Research Council (MRC) dyspnoea score was 3.9. High-resolution computed tomography (HRCT) results were reviewed to assess the presence of interlobar fissures. 33 patients had a follow-up of .12 months (median 32 months). 37.5% of the patients had visible interlobar fissures. 40% of the patients died during follow-up. Three patients were transplanted and one underwent lung volume reduction surgery. Supplemental oxygen, FEV1, RV, 6MWT and MRC score showed a statistically significant improvement (pf0.0001, p50.004, p50.03, p50.003 and p,0.0001, respectively). Patients with visible fissures had a functional advantage.BLVR is feasible and safe. Long-term sustained improvements can be achieved. HRCT-visible interlobar fissures are a favourable prognostic factor.

Endoscopic lung volume reduction in chronic obstructive airway disease using one-way valves

“…Regarding the longer term effects of Zephyr valves implantation, a study by Venuta et al [19] assessed the long term effects and also the clinical outcomes over 5 years. 40 patients were treated with Zephyr valves prior to Chartis being available.…”

Status of and prospects for bronchoscopic lung volume reduction for patients with severe emphysema

“…A long-term-survival study (n = 19) indicated that 5 patients who developed atelectasis in the target lobe survived 6 years after EBV implantation while 8 of 14 patients with no atelectasis died (21). Another study (n = 33) indicated that patients with atelectasis in the target lobe after EBV implantation had a better long-term survival (22).…”

Predictors of efficacy for endobronchial valves in bronchoscopic lung volume reduction

“…In the six different analyses, all except one (the analysis of 6MWD in the subgroup of participants in FIÀ group) did not reveal any outlier study. In the aforementioned subgroup analysis, the study by Venuta et al 7 was identified as the outlier. We also conducted separate analyses based on whether or not lobar occlusion was reported in studies including participants only in the FIþ group.…”