Endobronchial coils for endoscopic lung volume reduction: best practice recommendations from an expert panel
File(s)
Accepted version
Author(s)
Slebos, Dirk-Jan
Ten Hacken, Nick H
Hetzel, Martin
Herth, Felix JF
Shah, Pallav L
Type
Journal Article
Abstract
Endobronchial coils are an additional treatment option for lung volume reduction in patients with severe emphysema. Patient selection should be focused on patients with severe emphysema on optimal medical therapy and with evidence of severe hyperinflation. The technique is suitable in a broad range of patients with emphysema; however, patients with paraseptal emphysema, large focal (giant) bullae, significant co-morbidity and airway-predominant disease should be avoided. Treatment involves placing between 10 and 14 coils by bronchoscopy in the selected treatment lobe, with 2 lobes being treated sequentially. Lobe selection for treatment should be based on quantitative computed tomography, and the lobes with the greatest destruction should be targeted (excluding the right middle lobe). The treatment results in an improvement in pulmonary function, exercise performance and quality of life, particularly in patients with severe hyperinflation (residual volume > 200% predicted) and upper-lobe heterogeneous emphysema, but will also be of benefit in lower-lobe predominant and homogeneous emphysema. Finally, it has an acceptable safety profile, although special attention has to be paid to coil-associated opacity which is an inflammatory response that occurs in some patients treated with endobronchial coils.
Date Issued
2018-07-01
Date Acceptance
2018-05-21
Citation
Respiration, 2018, 96 (1), pp.1-11
ISSN
1423-0356
Publisher
Karger Publishers
Start Page
1
End Page
11
Journal / Book Title
Respiration
Volume
96
Issue
1
Copyright Statement
© 2018 S. Karger AG, Basel
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29991060
PII: 000490193
Subjects
Bronchoscopy
COPD
Endobronchial coils
Endoscopic lung volume reduction
Severe emphysema
Publication Status
Published
Coverage Spatial
Switzerland
Date Publish Online
2018-07-10