Low cost biological lung volume reduction therapy for advanced emphysema

Figures & data

Figure 1 Triple lumen balloon catheter and components of locally prepared fibrin glue.

Figure 2 (A) Triple lumen balloon catheter inserted into the targeted segment. (B) Inflated balloon prevent regurgitation of the injected materials.

Table 1 Age and baseline values in both groups

	Group A (n=7)	Group B (n=8)	P-value
Age (years) (mean ± SD)	55.71±4.03	56.50±12.08	0.873
COPD group (N [%])
GOLD III	1 (14.3%)	4 (50%)	0.143
GOLD IV	6 (85.7%)	4 (50%)
HRCT volumetry (mL) (mean ± SD)	1,643.71±94.19	1,479.38±799.01	0.581
RV/TLC (% predicted) (mean ± SD)	154±23	138±18	0.152
mMRC (mean ± SD)	3.29±0.49	3.38±0.52	0.738
SGRQ (mean ± SD)	65.68±12.48	68.14±18.47	0.771
6MWD (mean ± SD)	315.86±52.22	352.13±74.16	0.300
FEV1 (% predicted) (mean ± SD)	26±4	35±12	0.070
FEV1/FVC% (mean ± SD)	50±8	52±18	0.746
RV (% predicted) (mean ± SD)	122±12	115±4	0.157

Abbreviations: COPD, chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; HRCT, high resolution computerized tomography; mMRC, modified Medical Research Council; 6MWD, 6-minute walk distance; RV/TLC, residual volume/total lung capacity; SD, standard deviation; GOLD, Global Initiative for Chronic Obstructive Lung Disease; SGRQ, St George’s Respiratory Questionnaire.

Figure 3 HRCT with coronal reconstruction (A) and sagittal reconstruction (B) in patient who underwent BLVR with autologous blood.

Note: Reduction in emphysematous part at 12 weeks postprocedure (2) compared to baseline images (1).

Abbreviations: BLVR, bronchoscopic lung volume reduction; HRCT, high resolution computerized tomography.

Figure 4 HRCT with coronal reconstruction (A) and sagittal reconstruction (B) in patient who underwent BLVR with fibrin glue.

Note: Reduction in emphysematous part at 12 weeks postprocedure (2) compared to baseline images (1).
Abbreviations: BLVR, bronchoscopic lung volume reduction; HRCT, high resolution computerized tomography.

Table 2 Baseline values and changes in HRCT volumetry and RV/TLC (% predicted) after 12 weeks

	Baseline	12 weeks	Change	P-value*
HRCT volumetry (mL)
Group A (n=7)	1,643.71±94.19	918.67±167.22	−725±230	<0.001
Group B (n=8)	1,479.38±799.01	856.77±450.19	−622.6±435.4	0.005
P-value**	0.581	0.726
RV/TLC (% predicted)
Group A (n=7)	154±23	125±20	−29.14±29	0.038
Group B (n=8)	138±18	87±32	−51.12±34	0.004
P-value**	0.152	0.018

Notes:

* P-value within the group at 12 weeks in comparison to baseline.

** P-value between both groups. Data are presented as mean ± standard deviation.

Abbreviations: HRCT, high resolution computerized tomography; RV/TLC, residual volume/total lung capacity.

Table 3 Baseline and changes in secondary outcomes measures after 12 weeks

	Group A (n=7)			Group B (n=8)
	Baseline	12 weeks	P-value*	Baseline	12 weeks	P-value*	P-value**
mMRC	3.29±0.49	2.00±0.00	<0.001	3.38±0.52	2.13±0.35	0.002	0.351
SGRQ	65.68±12.48	37.55±5.47	<0.001	68.14±18.47	33.88±16.13	0.001	0.577
6MWD	315.86±52.22	331.29±52.95	<0.001	352.13±74.16	446.63±79.56	0.009	0.006
FEV1 (% predicted)	26±4	34±5	0.018	35±12	52±25	0.024	0.089
FEV1/FVC %	50±8	66±10	0.003	52±18	65±12	0.015	0.832

Notes:

* P-value within the group at 12 weeks in comparison to baseline.

** P-value between the groups at 12 weeks. Data are presented as mean ± standard deviation.

Abbreviations: FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; mMRC, modified Medical Research Council; 6MWD, 6-minute walk distance; SGRQ, St George’s Respiratory Questionnaire.