The lung volume reduction coil for the treatment of emphysema: a new therapy in development

Abstract

Lung volume reduction (LVR) coil treatment is a novel therapy for patients with severe emphysema. In this bilateral bronchoscopic treatment, approximately 10 LVR coils per lobe are delivered under fluoroscopic guidance in two sequential procedures. The LVR coil reduces lung volume by compressing the most destructed areas of the lung parenchyma and restores the lung elastic recoil. Both patients with upper- and lower-lobe predominant emphysema as well as a homogeneous emphysema distribution can be treated. LVR coil treatment results in an improvement of pulmonary function, exercise tolerance and quality of life. The LVR-coil treatment has been evaluated in several European clinical trials since 2008 and received CE mark approval in 2010. Currently, two large multicenter randomized controlled trials are underway in Europe and North America to assess the efficacy and safety of the LVR-coil treatment at 12 months compared with usual care. In this review, we share our experience with the LVR-coil treatment.

Keywords::

• bronchoscopic lung volume reduction
• COPD
• emphysema
• hyperinflation
• interventional pulmonology
• lung volume reduction
• nitinol

Financial & competing interests disclosure

K Klooster has received travel grants from PneumRx Inc. and financial support from PneumRx Inc. as a pulmonary function consultant. NH ten Hacken has no conflicts of interest. DJ Slebos has received travel grants and is a physician advisor to PneumRx Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

PneumRx Inc. was not involved in the writing of this manuscript.

Key issues

• The lung volume reduction (LVR)-coil procedure is a straightforward and safe procedure to perform.

• The LVR-coil treatment has an acceptable safety profile.

• The LVR-coil treatment reduces lung volume by compressing the most destructed areas of the lung parenchyma and restores the lung elastic recoil.

• The LVR-coil treatment results in an improvement of pulmonary function, exercise performance and quality of life.

• The LVR-coil treatment is effective in both upper- and lower-lobe predominant emphysema.

• Patients with homogeneous emphysema can benefit from the LVR-coil treatment.

• The efficacy of the LVR-coil treatment is independent of collateral flow.

Notes