Successful Bronchoscopic Lung Volume Reduction with New Lung Tensioning Device Coil: A Case Report

Abstract

Introduction Bronchoscopic lung volume reduction (BLVR) using endobronchial coil treatment is a widely studied therapeutic option in patients with end-stage chronic obstructive pulmonary disease (COPD) and pulmonary emphysema. However, patient responses were inconsistent, and, from 2020, production discontinuation rendered the treatment unavailable. In the meantime, a next-generation lung tensioning coil (LTD-coilFreeFlow Coil 4, FreeFlow Medical, Inc., California, USA) has been developed by the inventor of the lung volume reduction coil implant technology. This case study presents the first documented successful BLVR using LTD-coilFreeFlow Coils 4s. Case presentation A 68-year-old male patient with COPD, classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3, and homogenous emphysema with incomplete interlobar fissures was treated using the new developed LTD-coilFreeFlow Coils 4 in both upper lobes. Apart from a suspected coil associated opacity, no adverse events occurred. At the 18-week follow-up, a significant improvement in lung function and quality of life was observed, as measured by forced expiratory volume in one second (FEV1) (+150 mL), residual volume (RV) (- 0.50 L), 6-minute walking distance (6-MWD) (+ 75 meters) and the total score of the St. George's Respiratory Questionnaire (SGRQ) (-35 points). Conclusion BLVR with LTD-coilFreeFlow Coils 4 have shown promising outcomes, significantly improving both pulmonary function and quality of life in one patient. However, larger studies and randomized controlled trials are imperative to investigate the efficacy and safety profile of the new coil system.