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Coils for COPD

J Alberto Neder, Denis E O'Donnell
There has been a surge of interest in endoscopic lung volume reduction (ELVR) strategies for advanced COPD. Valve implants, coil implants, biological LVR (BioLVR), bronchial thermal vapour ablation, and airway stents are used to induce lung deflation with the ultimate goal of improving respiratory mechanics and chronic dyspnea. Patients presenting with severe air trapping (e.g., inspiratory capacity/total lung capacity (TLC) < 25%, residual volume > 225% predicted) and thoracic hyperinflation (TLC > 150% predicted) have the greatest potential to derive benefit from ELVR procedures...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Sergio Baldi, Francesco Coni, Giorgio Limerutti, Massimo Baccega, Enrico Ruffini, Paolo Solidoro
Endoscopic treatment of emphysema is supported by different methods, including valves, coils and sealants. The mechanism is mainly related to volume reduction of targeted area. Endobronchial valves (EBV) appear the most studied method. In a multicentre randomised study, placement of unidirectional endobronchial valves resulted in a statistically significant functional improvement in the treated cohort compared to the control. Adverse events, occurring post procedure, included COPD exacerbations, haemoptysis, pneumothorax and pneumonia...
2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Masamichi Mineshita, Takeo Inoue, Teruomi Miyazawa
Several non-surgical and minimally invasive bronchoscopic interventions, such as bronchoscopic lung volume reduction (BLVR) techniques, have been developed to treat patients with severe chronic obstructive pulmonary disease (COPD). BLVR has been studied for treatment in severe COPD patients with emphysema. BLVR with one-way endobronchial valves is reported to be effective for patients with a heterogeneous emphysema distribution and without inter-lobar collateral ventilation. For the patients with collateral ventilation, and for the patients with homogeneous emphysema, BLVR with lung volume reduction coil has shown promising results...
May 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Julian Arevalo-Ludeña, Jose Juan Arcas-Bellas, Rafael Alvarez-Rementería, Javier Flandes, Laura Morís, Luis E Muñoz Alameda
STUDY OBJECTIVE: To compare the use of the I-gel airway with orotracheal intubation (OTI) for bronchoscopic lung volume reduction (BLVR) coil treatment in patients with severe chronic obstructive pulmonary disease (COPD) with heterogeneous emphysema, since it has been proved that supraglottic airways have lower incidence of postoperative respiratory complaints compared to OTI. DESIGN: A comparative, prospective observational study was designed to assess the use of the I-gel airway compared with the OTI...
June 2016: Journal of Clinical Anesthesia
C Mascoli, A Freyrie, M Gargiulo, E Gallitto, R Pini, G Faggioli, C Serra, C De Molo, A Stella
OBJECTIVE: The pre-treatment presence of at least six efferent patent vessels (EPV) from the AAA sac and/or AAA thrombus volume ratio (VR%) <40% are considered to be positive predictive factors for persistent type II endoleak (ELIIp). The aim of the present study was to evaluate the effectiveness of sac embolization during EVAR in patients with pre-operative morphological risk factors (p-MRF) for ELIIp. METHODS: Patients undergoing EVAR and intra-procedural AAA sac embolization (Group A, 2012-2013) were retrospectively selected and compared with a control group of patients with the same p-MRF, who underwent EVAR without intra-procedural sac embolization (Group B, 2008-2010)...
May 2016: European Journal of Vascular and Endovascular Surgery
Ruby C Lo, Dominique B Buck, Jeremy Herrmann, Allen D Hamdan, Mark Wyers, Virendra I Patel, Mark Fillinger, Marc L Schermerhorn
OBJECTIVE: Type II endoleaks are common after endovascular aneurysm repair (EVAR), but their clinical significance remains undefined and their management controversial. We determined risk factors for type II endoleaks and associations with adverse outcomes. METHODS: We identified all EVAR patients in the Vascular Study Group of New England abdominal aortic aneurysm database. Patients were subdivided into two groups: (1) those with no endoleak or transient type II endoleak and (2) persistent type II endoleak or new type II endoleak (no endoleak at completion of case)...
April 2016: Journal of Vascular Surgery
Yanhong Liu, Farrah Kheradmand, Caleb F Davis, Michael E Scheurer, David Wheeler, Spiridon Tsavachidis, Georgina Armstrong, Claire Simpson, Diptasri Mandal, Elena Kupert, Marshall Anderson, Ming You, Donghai Xiong, Claudio Pikielny, Ann G Schwartz, Joan Bailey-Wilson, Colette Gaba, Mariza De Andrade, Ping Yang, Susan M Pinney, Christopher I Amos, Margaret R Spitz
INTRODUCTION: The association between smoking-induced chronic obstructive pulmonary disease (COPD) and lung cancer (LC) is well documented. Recent genome-wide association studies (GWAS) have identified 28 susceptibility loci for LC, 10 for COPD, 32 for smoking behavior, and 63 for pulmonary function, totaling 107 nonoverlapping loci. Given that common variants have been found to be associated with LC in genome-wide association studies, exome sequencing of these high-priority regions has great potential to identify novel rare causal variants...
January 2016: Journal of Thoracic Oncology
Askin Gulsen, Fidan Sever, Pelin Girgin, Necdet Batuhan Tamci, Hatice Yilmaz
INTRODUCTION: Bronchoscopic lung volume reduction coil (BLVR-C) implantation is an alternative therapeutic approach that can be applied together with medical treatment for patients with severe emphysema. BLVR-C is both easier and safer in terms of complications than volume reduction surgery. This study aimed to evaluate medium-term outcomes following BLVR-C treatment. METHODS: Forty patients who underwent BLVR-C between September 2013 and March 2014 were reviewed retrospectively...
September 14, 2015: Clinical Respiratory Journal
D Gompelmann, R Eberhardt, F J F Herth
Chronic obstructive pulmonary disease (COPD) is a widespread disease associated with high morbidity and mortality. The principal aim of therapy is preventing disease progression. Besides rehabilitation and pharmacological treatment, different endoscopic approaches were developed in the past decade extending the therapeutic spectrum. Various endoscopic lung volume reduction (ELVR) techniques are available that differ in the implementation, mechanism of action, complication spectrum, and reversibility. So far, the data on efficacy and safety are variable and still very limited...
August 2015: Seminars in Respiratory and Critical Care Medicine
B Storbeck, T H Schröder, M Oldigs, K F Rabe, C Weber
UNLABELLED: Chronic obstructive pulmonary disease (COPD) is characterized by two entities, the more airway-predominant type ("bronchitis") on the one hand, and emphysema-predominant type on the other. Imaging via high-resolution computed tomography plays an important role in phenotyping COPD. For patients with advanced lung emphysema, new endoscopic lung volume reduction therapies (ELVR) have been developed. Proper selection of suitable patients requires thin-section reconstruction of volumetric CT image data sets also in coronal and sagittal orientation are required...
July 2015: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Karin Klooster, Nick H T ten Hacken, Jorine E Hartman, Huib A M Kerstjens, Dirk-Jan Slebos
The current drug treatment of patients with severe and very severe COPD is often insufficient to achieve an acceptable quality of life. Surgical treatment of patients with COPD, by means of lung volume reduction surgery or lung transplantation is invasive and only available to a limited number of patients. Bronchoscopic lung volume reduction is a novel, minimally invasive, experimental treatment option for patients with severe COPD. Two different treatment options are currently available, depending on the type of pulmonary emphysema: bronchoscopic intervention with one-way endobronchial valves or with lung volume reduction coils...
2015: Nederlands Tijdschrift Voor Geneeskunde
Daniela Gompelmann, Ralf Eberhardt, Felix Herth
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is common in Germany, with a prevalence of 13.2%. The available treatments are exclusively symptomatic, except for lung transplantation, from which no more than a few patients can benefit. Over the past decade, endoscopic lung volume reduction (ELVR) has broadened the therapeutic spectrum for patients with advanced pulmonary emphysema. METHODS: We review pertinent publications that were retrieved from Pubmed using the search terms "endoscopic lung volume reduction," "endobronchial valves," "endobronchial coil," and "bronchoscopic thermal vapor ablation," along with current data from the annual meeting of the German Respiratory Society (Deutsche Gesellschaft für Pneumologie)...
December 5, 2014: Deutsches Ärzteblatt International
Michael A Trotter, Peter M Hopkins
Advanced chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity. Treatment options beyond conventional medical therapies are limited to a minority of patients. Lung volume reduction surgery (LVRS) although effective in selected subgroups of patients is not commonly undertaken. Morbidity associated with the procedure has contributed to this low utilisation. In response to this, less invasive bronchoscopic lung volume techniques are being developed to attempt to mitigate some of the risks and costs associated with surgery...
November 2014: Journal of Thoracic Disease
Masamichi Mineshita, Dirk-Jan Slebos
Over the past decade, several non-surgical and minimally invasive bronchoscopic lung volume reduction (BLVR) techniques have been developed to treat patients with severe chronic obstructive pulmonary disease (COPD). BLVR can be significantly efficacious, suitable for a broad cohort of patients, and associated with a solid safety profile at a reasonable expense. The introduction of BLVR is also expected to accelerate the further development of interventional pulmonology worldwide. Recently, results from clinical studies on BLVR techniques have been published, providing valuable information about the procedure's indications, contraindications, patient-selection criterion and outcomes...
November 2014: Respirology: Official Journal of the Asian Pacific Society of Respirology
Ashok Kumar Panjwani, Shaista Ghazal, Ravi Mahat, Maria Malik, Nadeem Rizvi
INTRODUCTION: Chronic obstructive pulmonary disease in non-smokers has been an important concern in past decade. We studied the risk factors responsible for more severe Chronic obstructive pulmonary disease. Identifying them would help to work against progression to more severe disease as well as prevention. METHODS: A prospective cross sectional study was done in outpatient clinic of Jinnah postgraduate medical center from December 2010 to December 2011. All patients fulfilling the criteria for Chronic obstructive pulmonary disease were taken in study...
July 2013: JNMA; Journal of the Nepal Medical Association
Konstantina Kontogianni, Vasiliki Gerovasili, Daniela Gompelmann, Maren Schuhmann, Claus Peter Heussel, Felix J F Herth, Ralf Eberhardt
BACKGROUND: Treatment with lung volume reduction coils (LVRC) may be effective in patients with severe heterogeneous emphysema and incomplete fissures. OBJECTIVE: We hypothesized that LVRC placement improves pulmonary function, exercise tolerance and quality of life in these patients. METHODS: Twenty-six patients with chronic obstructive pulmonary disease (COPD), 13 males and 13 females, aged 66 ± 8 years with heterogeneous emphysema and incomplete fissures were included in this retrospective analysis...
2014: Respiration; International Review of Thoracic Diseases
Edmond Cohen
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is a progressive, debilitating disease that in its final stages cripples the patient. The disappointing results of the National Emphysema Treatment Trial study led to a decrease in the acceptance of lung volume reduction surgery as a therapy. Thus, it became clear that debilitated COPD patients would need innovative alternative nonsurgical procedures to potentially alleviate their symptoms. This review will address the various techniques of bronchoscopic lung volume reduction (BLVR)...
February 2014: Current Opinion in Anaesthesiology
Si-Chang Xiao, Yi-Rong Lu, Hong-Xi Guo, Zhi-Hui Qiu, Yuan-Ming Luo
BACKGROUND: Neural respiratory drive is usually measured during inspiration, even in patients with chronic obstructive pulmonary disease (COPD) in whom the primary physiological deficit is expiratory flow limitation. The purpose of the study was to test the hypothesis that inspiratory muscle neural respiratory drive could be used to assess expiratory load. METHODS: Ten healthy young men, (26 ± 4) years old, were asked to expire through a tube immersed in water where an expiratory load was required...
October 2012: Chinese Medical Journal
Oskar Hallgren, Sara Rolandsson, Annika Andersson-Sjöland, Kristian Nihlberg, Elisabet Wieslander, Martina Kvist-Reimer, Magnus Dahlbäck, Leif Eriksson, Leif Bjermer, Jonas S Erjefält, Claes-Göran Löfdahl, Gunilla Westergren-Thorsson
BACKGROUND: During wound healing processes fibroblasts account for wound closure by adopting a contractile phenotype. One disease manifestation of COPD is emphysema which is characterized by destruction of alveolar walls and our hypothesis is that fibroblasts in the COPD lungs differentiate into a more contractile phenotype as a response to the deteriorating environment. METHODS: Bronchial (central) and parenchymal (distal) fibroblasts were isolated from lung explants from COPD patients (n = 9) (GOLD stage IV) and from biopsies from control subjects and from donor lungs (n = 12)...
2012: Journal of Translational Medicine
Dirk-Jan Slebos, Karin Klooster, Armin Ernst, Felix J F Herth, Huib A M Kerstjens
BACKGROUND: The lung volume reduction coil (LVR-coil), a new experimental device to achieve lung volume reduction by bronchoscopy in patients with severe emphysema, works in a manner unaffected by collateral airflow. We investigated the safety and efficacy of LVR-coil treatment in patients with heterogeneous emphysema. METHODS: In this prospective cohort pilot study, patients were treated bronchoscopically with Nitinol LVR-coils under fluoroscopic guidance in either one procedure or two sequential procedures...
September 2012: Chest
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