Journal article
Bronchoscopic thermal vapour ablation therapy in the management of heterogeneous emphysema
The European respiratory journal, Vol.39(6), pp.1326-1333
06/01/2012
DOI: 10.1183/09031936.00092411
PMID: 22075481
Abstract
The need for a less invasive procedure than surgical lung volume reduction that can produce consistent improvements with reduced morbidity remains a medical goal in patients with emphysema. We sought to determine the effect of bronchoscopic thermal vapour ablation (BTVA) on lung volumes and outcomes in patients with emphysema.
44 patients with upper lobe-predominant emphysema were treated unilaterally with BTVA. Entry criteria included: age 40-75 yrs, forced expiratory volume in 1 s (FEV1) 15-45% predicted, previous pulmonary rehabilitation and a heterogeneity index (tissue/air ratio of lower lobe/upper lobe) from high-resolution computed tomography (HRCT) >= 1.2. Changes in FEV1, St George's Respiratory Questionnaire (SGRQ), 6-min walk distance (6MWD), modified Medical Research Council (mMRC) dyspnoea score, and hyperinflation were measured at baseline, and 3 and 6 months post-BTVA.
At 6 months, mean +/- SE FEV1 improved by 141 +/- 26 mL (p<0.001) and residual volume was reduced by 406 +/- 113 mL (p<0.0001). SGRQ total score improved by 14.0 +/- 2.4 points (p<0.001), with 73% improving by >= 4 points. Improvements were observed in 6MWD (46.5 +/- 10.6 m) and mMRC dyspnoea score (0.9 +/- 0.2) (p<0.001 for both). Lower respiratory events (n=11) were the most common adverse event and occurred most often during the initial 30 days.
BTVA therapy results in clinically relevant improvements in lung function, quality of life and exercise tolerance in upper lobe predominant emphysema.
Details
- Title: Subtitle
- Bronchoscopic thermal vapour ablation therapy in the management of heterogeneous emphysema
- Creators
- Gregory Snell - Alfred Hosp, Melbourne, Vic 3004, AustraliaFelix J. F. Herth - Thoraxklin Heidelberg, Heidelberg, GermanyPeter Hopkins - Prince Charles HospitalKimberley M. Baker - Univ Iowa, Iowa City, IA USAChristian Witt - Charité - Universitätsmedizin BerlinMark H. Gotfried - PhoenixArschang Valipour - Otto Wagner HospitalManfred Wagner - Nuremberg HospitalFranz Stanzel - Zentrum für Pathologie und ZytodiagnostikJim J. Egan - University of IowaSteven Kesten - The Alfred HospitalArmin Ernst - St. Elizabeth's Medical Center
- Resource Type
- Journal article
- Publication Details
- The European respiratory journal, Vol.39(6), pp.1326-1333
- Publisher
- European Respiratory Soc Journals Ltd
- DOI
- 10.1183/09031936.00092411
- PMID
- 22075481
- ISSN
- 0903-1936
- eISSN
- 1399-3003
- Number of pages
- 8
- Grant note
- Uptake Medical Corp
- Language
- English
- Date published
- 06/01/2012
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984695830802771
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