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Semin Respir Crit Care Med 2018; 39(06): 685-692
DOI: 10.1055/s-0038-1676774
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bronchoscopic Lung Volume Reduction in Patients with Severe Emphysema

Sebastian Fernandez-Bussy
1   Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida
,
Gonzalo Labarca
2   Facultad de Medicina, Universidad San Sebastian, Concepcion, Chile
3   Complejo Asistencial Dr. Victor Rios Ruiz, Los Angeles, Región del Bío Bío, Chile
,
Felix J.F. Herth
4   Department of Pneumology and Critical Care Medicine, Thoraxklinik, Translational Lung Research Center Heidelberg, University of Heidelberg, Heidelberg, Germany
› Author Affiliations
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Publication History

Publication Date:
14 January 2019 (online)

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Abstract

Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure for patients with symptomatic severe emphysema who may not be candidates for surgical lung volume reduction. BLVR has been shown to improve both functional and clinical outcomes with a relatively low risk of severe complications. Any potential candidate to BLVR should be on optimal pharmacological and nonpharmacological treatment. Radiographic and pulmonary function testing provide key data to help identify potential BLVR candidates. A variety of BLVR techniques have been published with different associated benefits and risks. Current strategies include either blocking procedures such as endobronchial valves and intrabronchial valves or nonblocking procedures such as endobronchial coils and bronchoscopic thermal vapor ablation. The aim of this review is to describe current options of BLVR including their efficacy and safety based on available data.

Keywords

emphysema - bronchoscopy - endobronchial valve - bronchoscopic lung volume reduction
 

  • References

  • 1 Menezes AM, Perez-Padilla R, Jardim JR. , et al; PLATINO Team. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet 2005; 366 (9500): 1875-1881
    CrossrefPubMedGoogle Scholar
  • 2 Global Initiative for Chronic Obstructive Lung Disease (GOLD). Available at: http://www.goldcopd.org/ 2018 . Accessed September 2, 2018
    PubMed
  • 3 Horita N, Goto A, Shibata Y. , et al. Long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA) versus LABA plus inhaled corticosteroid (ICS) for stable chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev 2017; 2: CD012066
    PubMedGoogle Scholar
  • 4 Kew KM, Dias S, Cates CJ. Long-acting inhaled therapy (beta-agonists, anticholinergics and steroids) for COPD: a network meta-analysis. Cochrane Database Syst Rev 2014; (03) CD010844
    PubMedGoogle Scholar
  • 5 Mulhall P, Criner G. Non-pharmacological treatments for COPD. Respirology 2016; 21 (05) 791-809
    PubMedGoogle Scholar
  • 6 Chong J, Leung B, Poole P. Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2017; 9: CD002309
    PubMedGoogle Scholar
  • 7 Mineshita M, Slebos DJ. Bronchoscopic interventions for chronic obstructive pulmonary disease. Respirology 2014; 19 (08) 1126-1137
    CrossrefPubMedGoogle Scholar
  • 8 Gompelmann D, Herth FJ. Novel technologies in endoscopic lung volume reduction. Thorac Surg Clin 2016; 26 (02) 177-186
    CrossrefPubMedGoogle Scholar
  • 9 Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2016; 12: CD005305
    CrossrefPubMedGoogle Scholar
  • 10 Zephyr® Endobronchial Valve System - P180002. Available at: https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm614563.htm 2018 . Accessed September 16, 2018
    PubMed
  • 11 Sciurba FC, Ernst A, Herth FJ. , et al; VENT Study Research Group. A randomized study of endobronchial valves for advanced emphysema. N Engl J Med 2010; 363 (13) 1233-1244
    CrossrefPubMedGoogle Scholar
  • 12 Wood DE, Nader DA, Springmeyer SC. , et al; IBV Valve Trial Research Team. The IBV Valve trial: a multicenter, randomized, double-blind trial of endobronchial therapy for severe emphysema. J Bronchology Interv Pulmonol 2014; 21 (04) 288-297
    CrossrefPubMedGoogle Scholar
  • 13 Shah PL, Gompelmann D, Valipour A. , et al. Thermal vapour ablation to reduce segmental volume in patients with severe emphysema: STEP-UP 12 month results. Lancet Respir Med 2016; 4 (09) e44-e45
    CrossrefPubMedGoogle Scholar
  • 14 Herth FJ, Noppen M, Valipour A. , et al; International VENT Study Group. Efficacy predictors of lung volume reduction with Zephyr valves in a European cohort. Eur Respir J 2012; 39 (06) 1334-1342
    CrossrefPubMedGoogle Scholar
  • 15 Sciurba FC, Criner GJ, Strange C. , et al; RENEW Study Research Group. Effect of endobronchial coils vs usual care on exercise tolerance in patients with severe emphysema: the RENEW randomized clinical trial. JAMA 2016; 315 (20) 2178-2189
    CrossrefPubMedGoogle Scholar
  • 16 Deslée G, Mal H, Dutau H. , et al; REVOLENS Study Group. Lung volume reduction coil treatment vs usual care in patients with severe emphysema: the REVOLENS randomized clinical trial. JAMA 2016; 315 (02) 175-184
    CrossrefPubMedGoogle Scholar
  • 17 Herth FJF, Slebos DJ, Criner GJ, Shah PL. Endoscopic lung volume reduction: an expert panel recommendation - update 2017. Respiration 2017; 94 (04) 380-388
    CrossrefPubMedGoogle Scholar
  • 18 Fernández-Bussy S, Labarca G, Caviedes I, Mehta HJ, Jantz M, Majid A. Endoscopic lung volume reduction in advanced pulmonary emphysema: initial experience in Chile [in Spanish]. Rev Med Chil 2017; 145 (05) 667-672
    CrossrefPubMedGoogle Scholar
  • 19 Schuhmann M, Raffy P, Yin Y. , et al. Computed tomography predictors of response to endobronchial valve lung reduction treatment. Comparison with Chartis. Am J Respir Crit Care Med 2015; 191 (07) 767-774
    CrossrefPubMedGoogle Scholar
  • 20 Kontogianni K, Russell K, Eberhardt R. , et al. Clinical and quantitative computed tomography predictors of response to endobronchial lung volume reduction therapy using coils. Int J Chron Obstruct Pulmon Dis 2018; 13: 2215-2223
    CrossrefPubMedGoogle Scholar
  • 21 Gompelmann D, Eberhardt R, Slebos DJ. , et al. Diagnostic performance comparison of the Chartis System and high-resolution computerized tomography fissure analysis for planning endoscopic lung volume reduction. Respirology 2014; 19 (04) 524-530
    CrossrefPubMedGoogle Scholar
  • 22 Herth FJ, Slebos DJ, Rabe KF, Shah PL. Endoscopic lung volume reduction: an expert panel recommendation. Respiration 2016; 91 (03) 241-250
    CrossrefPubMedGoogle Scholar
  • 23 Herzog D, Poellinger A, Doellinger F. , et al. Modifying post-operative medical care after EBV implant may reduce pneumothorax incidence. PLoS One 2015; 10 (05) e0128097
    CrossrefPubMedGoogle Scholar
  • 24 Choi M, Lee WS, Lee M. , et al. Effectiveness of bronchoscopic lung volume reduction using unilateral endobronchial valve: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2015; 10: 703-710
    PubMedGoogle Scholar
  • 25 Gompelmann D, Herth FJ, Slebos DJ. , et al. Pneumothorax following endobronchial valve therapy and its impact on clinical outcomes in severe emphysema. Respiration 2014; 87 (06) 485-491
    CrossrefPubMedGoogle Scholar
  • 26 Ninane V, Geltner C, Bezzi M. , et al. Multicentre European study for the treatment of advanced emphysema with bronchial valves. Eur Respir J 2012; 39 (06) 1319-1325
    CrossrefPubMedGoogle Scholar
  • 27 Davey C, Zoumot Z, Jordan S. , et al. Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial. Lancet 2015; 386 (9998): 1066-1073
    CrossrefPubMedGoogle Scholar
  • 28 Klooster K, ten Hacken NH, Hartman JE, Kerstjens HA, van Rikxoort EM, Slebos DJ. Endobronchial valves for emphysema without interlobar collateral ventilation. N Engl J Med 2015; 373 (24) 2325-2335
    CrossrefPubMedGoogle Scholar
  • 29 Valipour A, Slebos DJ, Herth F. , et al. Endobronchial Valve Therapy in Patients with Homogeneous Emphysema. Results from the IMPACT Study. Am J Respir Crit Care Med. 2016; Nov 1; 194 (09) 1073-1082
    CrossrefPubMedGoogle Scholar
  • 30 van Agteren JE, Hnin K, Grosser D, Carson KV, Smith BJ. Bronchoscopic lung volume reduction procedures for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2017; 2: CD012158
    PubMedGoogle Scholar
  • 31 Kemp SV, Slebos DJ, Kirk A. , et al; TRANSFORM Study Team *. A multicenter randomized controlled trial of Zephyr endobronchial valve treatment in heterogeneous emphysema (TRANSFORM). Am J Respir Crit Care Med 2017; 196 (12) 1535-1543
    CrossrefPubMedGoogle Scholar
  • 32 Criner GJ, Sue R, Wright S. , et al. LIBERATE Study Group. A multicenter randomized controlled trial of Zephyr endobronchial valve treatment in heterogeneous emphysema (LIBERATE). Am J Respir Crit Care Med 2018; 198 (09) 1151-1164
    CrossrefPubMedGoogle Scholar
  • 33 Gompelmann D, Benjamin N, Bischoff E. , et al. Survival after endoscopic valve therapy in patients with severe emphysema. Respiration 2018; 1-8
    PubMedGoogle Scholar
  • 34 Wang Y, Lai TW, Xu F. , et al. Efficacy and safety of bronchoscopic lung volume reduction therapy in patients with severe emphysema: a meta-analysis of randomized controlled trials. Oncotarget 2017; 8 (44) 78031-78043
    CrossrefPubMedGoogle Scholar
  • 35 Eberhardt R, Gompelmann D, Schuhmann M. , et al. Complete unilateral vs partial bilateral endoscopic lung volume reduction in patients with bilateral lung emphysema. Chest 2012; 142 (04) 900-908
    CrossrefPubMedGoogle Scholar
  • 36 Fernandez-Bussy S, Labarca G, Majid A. Endoscopic lung volume reduction by endobronchial coils: first report from Latin America. J Bronchology Interv Pulmonol 2018; 25 (01) e4-e6
    CrossrefPubMedGoogle Scholar
  • 37 Herth FJ, Eberhard R, Gompelmann D, Slebos DJ, Ernst A. Bronchoscopic lung volume reduction with a dedicated coil: a clinical pilot study. Ther Adv Respir Dis 2010; 4 (04) 225-231
    CrossrefPubMedGoogle Scholar
  • 38 Slebos DJ, Klooster K, Ernst A, Herth FJF, Kerstjens HAM. Bronchoscopic lung volume reduction coil treatment of patients with severe heterogeneous emphysema. Chest 2012; 142 (03) 574-582
    CrossrefPubMedGoogle Scholar
  • 39 Shah PL, Zoumot Z, Singh S. , et al; RESET trial Study Group. Endobronchial coils for the treatment of severe emphysema with hyperinflation (RESET): a randomised controlled trial. Lancet Respir Med 2013; 1 (03) 233-240
    CrossrefPubMedGoogle Scholar
  • 40 Snell GI, Hopkins P, Westall G, Holsworth L, Carle A, Williams TJ. A feasibility and safety study of bronchoscopic thermal vapor ablation: a novel emphysema therapy. Ann Thorac Surg 2009; 88 (06) 1993-1998
    CrossrefPubMedGoogle Scholar
  • 41 Roetting M, Gompelmann D, Herth FJF. Thermic and chemical procedures for bronchoscopic lung volume reduction. J Thorac Dis 2018; 10 (Suppl. 23) S2806-S2810
    CrossrefPubMedGoogle Scholar
  • 42 Ramaswamy A, Puchalski J. Bronchoscopic lung volume reduction: recent updates. J Thorac Dis 2018; 10 (04) 2519-2527
    CrossrefPubMedGoogle Scholar
  • 43 Gompelmann D, Shah PL, Valipour A, Herth FJF. Bronchoscopic thermal vapor ablation: best practice recommendations from an expert panel on endoscopic lung volume reduction. Respiration 2018; 95 (06) 392-400
    CrossrefPubMedGoogle Scholar
  • 44 Herth FJ, Valipour A, Shah PL. , et al. Segmental volume reduction using thermal vapour ablation in patients with severe emphysema: 6-month results of the multicentre, parallel-group, open-label, randomised controlled STEP-UP trial. Lancet Respir Med 2016; 4 (03) 185-193
    CrossrefPubMedGoogle Scholar