Abstract
Endoscopic lung volume reduction (ELVR) therapies are gaining prominence as a treatment option with guideline recommendations by COPD GOLD and NICE and the recent FDA approval for endobronchial valves. The transition from an experiment-based therapy only to clinical care comes with new challenges. A significant volume of evidence-based data has been published; all data demonstrate consistent improvements in several aspects of patient outcomes. Patients suffering from severe air trapping and thoracic hyperinflation seem to benefit the most from ELVR. In addition to lung function, baseline assessment should ideally include cardiopulmonary exercise testing, high-resolution computer tomography scan, perfusion scintigraphy, and echocardiography. This expert ELVR statement updates best practice recommendations from 2017 regarding patient selection and utilization of these various techniques for treating patients with advanced emphysema.
References
1.
Murray
CJ
, Lopez
AD
. Measuring the global burden of disease
. N Engl J Med
. 2013
Aug
;369
(5
):448
–57
.
[PubMed]
0028-47932.
Vogelmeier
CF
, Criner
GJ
, Martinez
FJ
, Anzueto
A
, Barnes
PJ
, Bourbeau
J
, et al.; Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report
. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary
. Am J Respir Crit Care Med
. 2017
Mar
;195
(5
):557
–82
.
[PubMed]
1073-449X3.
Kim
V
, Criner
GJ
. Chronic bronchitis and chronic obstructive pulmonary disease
. Am J Respir Crit Care Med
. 2013
Feb
;187
(3
):228
–37
.
[PubMed]
1073-449X4.
Hogg
JC
, Paré
PD
, Hackett
TL
. The Contribution of Small Airway Obstruction to the Pathogenesis of Chronic Obstructive Pulmonary Disease
. Physiol Rev
. 2017
Apr
;97
(2
):529
–52
.
[PubMed]
0031-93335.
Marchetti
N
, Criner
GJ
. Surgical Approaches to Treating Emphysema: Lung Volume Reduction Surgery, Bullectomy, and Lung Transplantation
. Semin Respir Crit Care Med
. 2015
Aug
;36
(4
):592
–608
.
[PubMed]
1069-34246.
Halbert
RJ
, Natoli
JL
, Gano
A
, Badamgarav
E
, Buist
AS
, Mannino
DM
. Global burden of COPD: systematic review and meta-analysis
. Eur Respir J
. 2006
Sep
;28
(3
):523
–32
.
[PubMed]
0903-19367.
Herth
FJ
, Slebos
DJ
, Rabe
KF
, Shah
PL
. Endoscopic Lung Volume Reduction: An Expert Panel Recommendation
. Respiration
. 2016
;91
(3
):241
–50
.
[PubMed]
1423-03568.
Herth
FJ
, Slebos
DJ
, Criner
GJ
, Shah
PL
. Endoscopic Lung Volume Reduction: An Expert Panel Recommendation - Update 2017
. Respiration
. 2017
;94
(4
):380
–8
.
[PubMed]
1423-03569.
The Global Strategy for Diagnosis
. Management and Prevention of COPD, updated
. 2019
. https://goldcopd.org/gold-reports/10.
Excellence
NI
. Endobronchial valve insertion to reduce lung volume in emphysema.
nice.org.uk/guidance/ipg600, 2017
.11.
van Geffen
WH
, S.D., Herth FJ, Kemp SV, Weder W, Shah PL., Surgical and endoscopic interventions that reduce lung volume for emphysema: a systemic review and meta-analysis. Lancet Respir Med, 2018
: p. accepted.12.
Eberhardt
R
, Gerovasili
V
, Kontogianni
K
, Gompelmann
D
, Ehlken
N
, Herth
FJ
, et al. Endoscopic lung volume reduction with endobronchial valves in patients with severe emphysema and established pulmonary hypertension
. Respiration
. 2015
;89
(1
):41
–8
.
[PubMed]
1423-035613.
Darwiche
K
, Karpf-Wissel
R
, Eisenmann
S
, Aigner
C
, Welter
S
, Zarogoulidis
P
, et al. Bronchoscopic Lung Volume Reduction with Endobronchial Valves in Low-FEV1 Patients
. Respiration
. 2016
;92
(6
):414
–9
.
[PubMed]
1423-035614.
Trudzinski
FC
, Höink
AJ
, Leppert
D
, Fähndrich
S
, Wilkens
H
, Graeter
TP
, et al. Endoscopic Lung Volume Reduction Using Endobronchial Valves in Patients with Severe Emphysema and Very Low FEV1
. Respiration
. 2016
;92
(4
):258
–65
.
[PubMed]
1423-035615.
Mets
OM
, de Jong
PA
, Prokop
M
. Computed tomographic screening for lung cancer: an opportunity to evaluate other diseases
. JAMA
. 2012
Oct
;308
(14
):1433
–4
.
[PubMed]
0098-748416.
Labaki
WW
, Martinez
CH
, Martinez
FJ
, Galbán
CJ
, Ross
BD
, Washko
GR
, et al. The Role of Chest Computed Tomography in the Evaluation and Management of the Patient with Chronic Obstructive Pulmonary Disease
. Am J Respir Crit Care Med
. 2017
Dec
;196
(11
):1372
–9
.
[PubMed]
1073-449X17.
Mets
OM
, Smit
EJ
, Mohamed Hoesein
FA
, Gietema
HA
, Bokkers
RP
, Attrach
M
, et al. Visual versus automated evaluation of chest computed tomography for the presence of chronic obstructive pulmonary disease
. PLoS One
. 2012
;7
(7
):e42227
.
[PubMed]
1932-620318.
Koster
TD
, van Rikxoort
EM
, Huebner
RH
, Doellinger
F
, Klooster
K
, Charbonnier
JP
, et al. Predicting Lung Volume Reduction after Endobronchial Valve Therapy Is Maximized Using a Combination of Diagnostic Tools
. Respiration
. 2016
;92
(3
):150
–7
.
[PubMed]
1423-035619.
Herth
FJ
, Eberhardt
R
, Gompelmann
D
, Ficker
JH
, Wagner
M
, Ek
L
, et al. Radiological and clinical outcomes of using Chartis™ to plan endobronchial valve treatment
. Eur Respir J
. 2013
Feb
;41
(2
):302
–8
.
[PubMed]
0903-193620.
Welling
JB
, Hartman
JE
, Ten Hacken
NH
, Franz
I
, Charbonnier
JP
, van Rikxoort
EM
, et al. Chartis Measurement of Collateral Ventilation: Conscious Sedation versus General Anesthesia - A Retrospective Comparison
. Respiration
. 2018
;96
(5
):480
–7
.
[PubMed]
1423-035621.
Sciurba
FC
, Ernst
A
, Herth
FJ
, Strange
C
, Criner
GJ
, Marquette
CH
, et al.; VENT Study Research Group
. A randomized study of endobronchial valves for advanced emphysema
. N Engl J Med
. 2010
Sep
;363
(13
):1233
–44
.
[PubMed]
0028-479322.
Valipour
A
, Slebos
DJ
, Herth
F
, Darwiche
K
, Wagner
M
, Ficker
JH
, et al.; IMPACT Study Team
. Endobronchial Valve Therapy in Patients with Homogeneous Emphysema. Results from the IMPACT Study
. Am J Respir Crit Care Med
. 2016
Nov
;194
(9
):1073
–82
.
[PubMed]
1073-449X23.
Kemp
SV
. S.D., Kirk A., Kornaszewska M., Carron K., Ek L., Mal H., Pison V., Downer N.J., Broman N., Darwiche K., Rao J., Hubner R., Trosini-Desert V., Eberhardt R., Herth F.J.F., Derom E., Marquette C.H., A Multicenter, Prospective, Randomized, Controlled Trial of Endobronchial Valve Treatment vs Standard of Care in Heterogeneous Emphysema (TRANSFORM)
. Am J Respir Crit Care Med
. 2017
;195
:A6740
.1073-449X24.
Herth
FJ
, Noppen
M
, Valipour
A
, Leroy
S
, Vergnon
JM
, Ficker
JH
, et al.; International VENT Study Group
. Efficacy predictors of lung volume reduction with Zephyr valves in a European cohort
. Eur Respir J
. 2012
Jun
;39
(6
):1334
–42
.
[PubMed]
0903-193625.
Klooster
K
, ten Hacken
NN
, Slebos
DJ
. Endobronchial Valves for Emphysema
. N Engl J Med
. 2016
Apr
;374
(14
):1390
.
[PubMed]
1533-440626.
Davey
C
, Zoumot
Z
, Jordan
S
, McNulty
WH
, Carr
DH
, Hind
MD
, et al. Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial
. Lancet
. 2015
Sep
;386
(9998
):1066
–73
.
[PubMed]
0140-673627.
Criner
GJ
, et al. A Multicenter RCT of Zephyr(R) Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE)
. Am J Respir Crit Care Med
. 2018
. 1073-449X28.
Wang
G
, S.l., Changhui W, Xinglin G, Faguang J, Huaping Y, Baohui H, Rui Z, Chengshui C, Liangan C, Chunxue B, Huahao S, Nanshan Z., Eur Respi J. The REACH study, a randomized controlled trial assessing the safety and effectiveness of the Spiration Valve System endobronchial therapy for severe emphysema: 12 month follow-up results., 2018
. 50: p. OA 1465.29.
Criner
GD
, Voelker
K
, et al. Endobronchial Valves for Severe Emphysema – 12-month Results of the EMPROVE Trial. Eur Respir J, 2018
: p. OA 4928.30.
Gompelmann
D
, Benjamin
N
, Kontogianni
K
, Herth
F
, Heussel
CP
, Hoffmann
H
, et al. Clinical and radiological outcome following pneumothorax after endoscopic lung volume reduction with valves
. Int J Chron Obstruct Pulmon Dis
. 2016
Dec
;11
:3093
–9
.
[PubMed]
1176-910631.
Gompelmann
D
, Herth
FJ
, Slebos
DJ
, Valipour
A
, Ernst
A
, Criner
GJ
, et al. Pneumothorax following endobronchial valve therapy and its impact on clinical outcomes in severe emphysema
. Respiration
. 2014
;87
(6
):485
–91
.
[PubMed]
1423-035632.
van Geffen
WH
, Klooster
K
, Hartman
JE
, Ten Hacken
NH
, Kerstjens
HA
, Wolf
RF
, et al. Pleural Adhesion Assessment as a Predictor for Pneumothorax after Endobronchial Valve Treatment
. Respiration
. 2017
;94
(2
):224
–31
.
[PubMed]
1423-035633.
Gompelmann
D
, Lim
HJ
, Eberhardt
R
, Gerovasili
V
, Herth
FJ
, Heussel
CP
, et al. Predictors of pneumothorax following endoscopic valve therapy in patients with severe emphysema
. Int J Chron Obstruct Pulmon Dis
. 2016
Aug
;11
:1767
–73
.
[PubMed]
1176-910634.
Valipour
A
, Slebos
DJ
, de Oliveira
HG
, Eberhardt
R
, Freitag
L
, Criner
GJ
, et al. Expert statement: pneumothorax associated with endoscopic valve therapy for emphysema—potential mechanisms, treatment algorithm, and case examples
. Respiration
. 2014
;87
(6
):513
–21
.
[PubMed]
1423-035635.
Klooster
K
, Hartman
JE
, Ten Hacken
NH
, Slebos
DJ
. Improved Predictors of Survival after Endobronchial Valve Treatment in Patients with Severe Emphysema
. Am J Respir Crit Care Med
. 2017
May
;195
(9
):1272
–4
.
[PubMed]
1073-449X36.
Gompelmann
D, B.N.
, Bischoff
E
, Kontogianni
K
, Schuhmann
M
, Hoffmann
H
, Heussel
CP
, Herth
FJF
, Eberhardt
R
, Survival after endoscopic valve therapy in patients with severe emphysema.
Respiration, 2018
(epub ahead). 37.
Garner
J
, Kemp
SV
, Toma
TP
, Hansell
DM
, Polkey
MI
, Shah
PL
, et al. Survival after Endobronchial Valve Placement for Emphysema: A 10-Year Follow-up Study
. Am J Respir Crit Care Med
. 2016
Aug
;194
(4
):519
–21
.
[PubMed]
1073-449X38.
Shah
PL
, Zoumot
Z
, Singh
S
, Bicknell
SR
, Ross
ET
, Quiring
J
, et al.; RESET trial Study Group
. Endobronchial coils for the treatment of severe emphysema with hyperinflation (RESET): a randomised controlled trial
. Lancet Respir Med
. 2013
May
;1
(3
):233
–40
.
[PubMed]
2213-260039.
Klooster
K
, Ten Hacken
NH
, Franz
I
, Kerstjens
HA
, van Rikxoort
EM
, Slebos
DJ
. Lung volume reduction coil treatment in chronic obstructive pulmonary disease patients with homogeneous emphysema: a prospective feasibility trial
. Respiration
. 2014
;88
(2
):116
–25
.
[PubMed]
1423-035640.
Kontogianni
K
, Gerovasili
V
, Gompelmann
D
, Schuhmann
M
, Hoffmann
H
, Heussel
CP
, et al. Coil therapy for patients with severe emphysema and bilateral incomplete fissures - effectiveness and complications after 1-year follow-up: a single-center experience
. Int J Chron Obstruct Pulmon Dis
. 2017
Jan
;12
:383
–94
.
[PubMed]
1176-910641.
Slebos
DJ
, Hartman
JE
, Klooster
K
, Blaas
S
, Deslee
G
, Gesierich
W
, et al. Bronchoscopic Coil Treatment for Patients with Severe Emphysema: A Meta-Analysis
. Respiration
. 2015
;90
(2
):136
–45
.
[PubMed]
1423-035642.
Deslée
G
, Mal
H
, Dutau
H
, Bourdin
A
, Vergnon
JM
, Pison
C
, et al.; REVOLENS Study Group
. Lung Volume Reduction Coil Treatment vs Usual Care in Patients With Severe Emphysema: The REVOLENS Randomized Clinical Trial
. JAMA
. 2016
Jan
;315
(2
):175
–84
.
[PubMed]
0098-748443.
Sciurba
FC
, Criner
GJ
, Strange
C
, Shah
PL
, Michaud
G
, Connolly
TA
, et al.; RENEW Study Research Group
. Effect of Endobronchial Coils vs Usual Care on Exercise Tolerance in Patients With Severe Emphysema: The RENEW Randomized Clinical Trial
. JAMA
. 2016
May
;315
(20
):2178
–89
.
[PubMed]
0098-748444.
Herth
FJ
, Valipour
A
, Shah
PL
, Eberhardt
R
, Grah
C
, Egan
J
, et al. Segmental volume reduction using thermal vapour ablation in patients with severe emphysema: 6-month results of the multicentre, parallel-group, open-label, randomised controlled STEP-UP trial
. Lancet Respir Med
. 2016
Mar
;4
(3
):185
–93
.
[PubMed]
2213-260045.
Shah
PL
, Gompelmann
D
, Valipour
A
, McNulty
WH
, Eberhardt
R
, Grah
C
, et al. Thermal vapour ablation to reduce segmental volume in patients with severe emphysema: STEP-UP 12 month results
. Lancet Respir Med
. 2016
Sep
;4
(9
):e44
–5
.
[PubMed]
2213-260046.
Come
CE
, Kramer
MR
, Dransfield
MT
, Abu-Hijleh
M
, Berkowitz
D
, Bezzi
M
, et al. A randomised trial of lung sealant versus medical therapy for advanced emphysema
. Eur Respir J
. 2015
Sep
;46
(3
):651
–62
.
[PubMed]
0903-193647.
Kramer
MR
, Refaely
Y
, Maimon
N
, Rosengarten
D
, Fruchter
O
. Bilateral endoscopic sealant lung volume reduction therapy for advanced emphysema
. Chest
. 2012
Nov
;142
(5
):1111
–7
.
[PubMed]
0012-369248.
Herth
FJ
, Gompelmann
D
, Stanzel
F
, Bonnet
R
, Behr
J
, Schmidt
B
, et al. Treatment of advanced emphysema with emphysematous lung sealant (AeriSeal®)
. Respiration
. 2011
;82
(1
):36
–45
.
[PubMed]
1423-035649.
Fuehner
T
, Clajus
C
, Fuge
J
, Jonigk
D
, Welte
T
, Haverich
A
, et al. Lung transplantation after endoscopic lung volume reduction
. Respiration
. 2015
;90
(3
):243
–50
.
[PubMed]
1423-035650.
Li S, Wang G, Wang C, Gao X, Jin F, Yang H, Han B, Zhou R, Chen C, Chen L, Bai C, Shen H, Herth FJF, Zhong N. The REACH Trial: A Randomized Controlled Trial Assessing the Safety and Effectiveness of the Spiration® Valve System in the Treatment of Severe Emphysema. Respiration. DOI: 10.1159/000494327. Epub ahead of print.
51.
Deslée G, Mal H, Dutau H, Bourdin A, Vergnon JM, Pison C, Kessler R, Jounieaux V, Thiberville L, Leroy S, Marceau A, Laroumagne S, Mallet JP, Dukic S, Barbe C, Bulsei J, Jolly D, Durand-Zaleski I, Marquette CH; REVOLENS Study Group. Lung Volume Reduction Coil Treatment vs Usual Care in Patients With Severe Emphysema: The REVOLENS Randomized Clinical Trial. JAMA. 2016 Jan 12;315(2):175–84.
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