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

Respirology. 2015 Feb;20(2):319-26. doi: 10.1111/resp.12435. Epub 2014 Nov 23.


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 (6MWD) 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 6MWD minimal important difference, and 59% for the St George's Respiratory Questionnaire (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 6MWD, SGRQ and mMRC.

Clinical trial registration: NCT01220908 and NCT01328899 registered at ClinicalTrials.gov.

Keywords: bronchoscopy and interventional technique; clinical respiratory medicine; coil; emphysema; long-term follow-up.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Bronchoscopy / adverse effects*
  • Bronchoscopy / instrumentation*
  • Bronchoscopy / methods
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Humans
  • Lung Volume Measurements
  • Male
  • Middle Aged
  • Pilot Projects
  • Pulmonary Emphysema / physiopathology*
  • Pulmonary Emphysema / therapy*
  • Residual Volume
  • Surveys and Questionnaires
  • Time Factors

Associated data

  • ClinicalTrials.gov/NCT01220908
  • ClinicalTrials.gov/NCT01328899