Lung Volume Reduction Coil Treatment vs Usual Care in Patients With Severe Emphysema

Abstract

clinicaltrials.gov Identifier: NCT01822795.

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

“…In a multicenter RCT, known as the REVOLENS trial, 100 patients with bilateral emphysema were assigned to receive LVRC treatment or standard care. After 6 months, significantly more patients in the treatment group (n = 50) had an improvement of 54 m in the 6MWT in comparison to the control group (n = 50) (36% of patients, n = 18 vs. 17% of patients, n = 9), although the absolute between-group difference in results on the 6MWT was only modest (21 m) (66). The study sample was carefully selected to include patients with a residual volume greater than 220% of the predicted volume, which represents a higher degree of expiratory air trapping and contrasts with the 150% predicted volume specified in inclusion criteria for most BLVR trials.…”

Endobronchial coils – therapeutic innovations for severe emphysema

“…Coils are applicated bilaterally in two interventions. Currently, two first-in-man studies [6,7], three feasibility trials [8][9][10]9 and one published randomized controlled (RCT) pivotal [12] study confirm the benefit of the technology for patients with severe emphysema.…”

“…A quite well studied endoscopic method is the minimally invasive, non-surgical procedure with coils [6][7][8][9][10][11][12][13]. Coils are small, shape-memory Nitinol implants designed to gather and compress lung tissue, re-tension the diseased airway network and increase the elastic recoil in the emphysematous lung.…”

“…The REVOLENS trial [12] by Gaetan Deslee was published in January 2016. 100 patients were enrolled in 10 sites throughout France.…”

Individualized Care in COPD: Updated Guidelines from Revised GOLD 2017 Report

“…Bullectomy, bronchoscopic lung volume reduction (BLVR) and lung volume reduction surgery (LVRS) improve health outcomes in carefully selected subset of patients [66][67][68][69]. Extent and pattern of emphysema on high-resolution computed tomography (HRCT), presence of inter-lobar collateral ventilation, patient and provider preferences and local expertise are important considerations when considering invasive treatment options for patients.…”