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Endobronchial Coils Versus Lung Volume Reduction Surgery or Medical Therapy for Treatment of Advanced Homogenous Emphysema.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Marchetti, Nathaniel Kaufman, Theresa Chandra, Divay Herth, Felix J. F. Shah, Pallav L. Slebos, Dirk-Jan Dass, Chandra A. Bicknell, Stephen R. Blaas, Stefan H. Pfeifer, Michael Stanzell, Franz Witt, Claudia. Deslée, Gaëtan Gesierich, Wolfgang Hetzel, Martin Kessler, Romain Leroy, Sylvie Hetzel, Jürgen Robert Sciurba, Frank C. Criner, Gerard |
| Copyright Year | 2018 |
| Abstract | Rationale: Bronchoscopic lung volume reduction utilizing shape-memory nitinol endobronchial coils (EBC) may be safer and more effective in severely hyperinflated homogeneous emphysema compared to medical therapy or lung volume reduction surgery (LVRS). Methods: The effect of bilateral EBC in patients with homogeneous emphysema on spirometry, lung volumes and survival was compared to patients with homogeneous emphysema randomized in the National Emphysema Treatment Trial (NETT) to LVRS or medical therapy. NETT participants were selected to match EBC participants in age, baseline spirometry, and gender. Outcomes were compared from baseline, at 6 and 12 months. Results: There were no significant baseline differences in gender in the EBC, NETT-LVRS or medical treatment patients. At baseline no differences existed between EBC and NETT-LVRS patients in forced expiratory volume in 1 second ( FEV1) or total lung capacity (TLC) %-predicted; residual volume (RV) and diffusing capacity of the lung for carbon monoxide (DLco) %-predicted were higher in the EBC group compared to NETT-LVRS (p < 0.001). Compared to the medical treatment group, EBC produced greater improvements in FEV1 and RV but not TLC at 6 months. FEV1 and RV in the EBC group remained significantly improved at 12-months compared to the medical treatment group. While all 3 therapies improved quality of life, survival at 12 months with EBC or medical therapy was greater than NETT-LVRS. Conclusion: EBC may be a potential therapeutic option in patients with severe homogeneous emphysema and hyperinflation who are already receiving optimal medical treatment. |
| Starting Page | 87 |
| Ending Page | 96 |
| Page Count | 10 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://journal.copdfoundation.org/Portals/0/JCOPDF/Files/Volume5-Issue2/JCOPDF-2017-0134-Marchetti.pdf |
| PubMed reference number | 30374446v1 |
| Alternate Webpage(s) | https://doi.org/10.15326/jcopdf.5.2.2017.0134 |
| DOI | 10.15326/jcopdf.5.2.2017.0134 |
| Journal | Chronic obstructive pulmonary diseases |
| Volume Number | 5 |
| Issue Number | 2 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | BaseLine dental cement Bronchial Provocation Tests Capacity.total:Volume:Point in time:Respiratory system:Quantitative Carbon Monoxide Expiration, function Forced expiratory volume function Hyperinflation Lung diseases Pathological accumulation of air in tissues Patients Pulmonary Emphysema Pulmonary Function Test/Forced Expiratory Volume 1 Residual volume Spirometry Structure of parenchyma of lung Therapeutic procedure lung volume reduction surgery nitinol |
| Content Type | Text |
| Resource Type | Article |
