The potential for bronchoscopic lung volume reduction using bronchial prostheses: a pilot study.

摘要: Study objectives: Significant morbidity and mortality offset the benefits of lung volume reduction surgery (LVRS) for emphysema. By contributing to distal collapse, bronchoscopic placement valved prostheses has potential noninvasively replicate beneficial effects LVRS. The purpose this study was investigate safety feasibility placing valves in segmental airways patients with Design: Case series. Setting: Tertiary hospital, severe disease clinic. Patients: Ten aged 51 69 years apical emphysema hyperinflation, otherwise suitable standard Mean preoperative FEV 1 0.72 L (19 46% predicted), 6-min walk distance 340 m (range, 245 425 m). Intervention: Apical, bronchoscopic, airway one-way (silicone-based Nitinol bronchial stent; Emphasys Medical; Redwood City, CA) under general anesthesia. Placement over a guidewire fluoroscopic control. Results: Four 11 per patient took 52 137 min obstruct upper-lobe segments bilaterally. Inpatient stay 8 days. No major complications were seen 30-day period. Minor included exacerbation COPD (n = 3), asymptomatic localized pneumothorax 1), lower-lobe pneumonia (day 37; n 1). Symptomatic improvement noted four patients. change radiologic findings, function, or evident at month, although gas transfer improved from 7.47 ± 2.0 8.26 2.6 mL/min/mm Hg (p 0.04) nuclear perfusion fell 32 10 27 9% (mean SD) [p 0.02]. Conclusion: Bronchoscopic can be safely reliably placed into human lung. Further is needed explore characteristics that determine symptomatic efficacy larger cohort.