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Bronchoscopic Coil Treatment for Patients with Severe Emphysema: A Meta-Analysis

Slebos, D-J., Hartman, J. E., Klooster, K., Blaas, S., Deslee, G., Gesierich, W., Hetzel, J., Hetzel, M., McNulty, W., Kemp, S. V., Kessler, R., Leroy, S., Stanzel, F., Witt, C., Zoumot, Z., Herth, F. J. F. & Shah, P. L., Aug-2015, In : Respiration. 90, 2, p. 136-145 10 p.

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  • Bronchoscopic Coil Treatment for Patients with Severe Emphysema A Meta-Analysis

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DOI

  • Dirk-Jan Slebos
  • Jorine E. Hartman
  • Karin Klooster
  • Stefan Blaas
  • Gaetan Deslee
  • Wolfgang Gesierich
  • Juergen Hetzel
  • Martin Hetzel
  • William McNulty
  • Samuel V. Kemp
  • Romain Kessler
  • Sylvie Leroy
  • Franz Stanzel
  • Christian Witt
  • Zaid Zoumot
  • Felix J. F. Herth
  • Pallav L. Shah

Background: Bronchoscopic coil treatment has been shown to improve pulmonary function, exercise capacity, and quality of life in patients with severe emphysema. Objectives: To perform a meta-analysis of the results of four independent European clinical trials investigating this coil therapy for emphysema. Methods: Data on all patients included in the four European clinical trials were analyzed for efficacy and safety outcomes. Results: A total of 2,536 coils were placed during 259 procedures in 140 patients. A total of 37 chronic obstructive pulmonary disease exacerbations and 27 pneumonias were recorded as serious adverse events up to 1 year after treatment. The pneumothorax rate was 6.4%. Both 6 and 12 months after treatment, significant (all p <0.001) improvements were observed for: forced expiratory volume in 1 s [+0.08 liters (+/- 0.19) and +0.08 liters (+/- 0.21)], residual volume [RV; -510 ml (+/- 850) and -430 ml (+/- 720)], 6-min walking distance [6MWD; +44.1 m (+/- 69.8) and +38.1 m (+/- 71.9)], and St. George's Respiratory Questionnaire score [SGRQ; -9.5 points (+/- 14.3) and -7.7 points (+/- 14.2)]. No differences in any outcome measures were observed between heterogeneous and homogeneous emphysema patients. Only a high baseline RV was found to be an independent predictor of successful treatment. Conclusions: Bronchoscopic coil treatment improves pulmonary function, 6MWD, and quality of life in patients with severe emphysema up to 1 year after treatment, independent of the distribution of the disease. (C) 2015 S. Karger AG, Basel

Original languageEnglish
Pages (from-to)136-145
Number of pages10
JournalRespiration
Volume90
Issue number2
Publication statusPublished - Aug-2015

    Keywords

  • Chronic obstructive pulmonary disease, Emphysema, Bronchoscopic lung volume reduction, LUNG-VOLUME-REDUCTION, OBSTRUCTIVE PULMONARY-DISEASE, MINIMAL IMPORTANT DIFFERENCE, MULTICENTER TRIAL, THERAPY, STANDARDIZATION

ID: 24119465