Lung volume reduction with vapor ablation in the presence of incomplete fissures

• Verfasst von: Gompelmann, Daniela [VerfasserIn]
• Verfasst von: Eberhardt, Ralf [VerfasserIn]
• Verfasst von: Schuhmann, Maren [VerfasserIn]
• Verfasst von: Valipour, Arschang [VerfasserIn]
• Verfasst von: Shah, Pallav [VerfasserIn]
• Verfasst von: Herth, Felix [VerfasserIn]
• Verfasst von: Kontogianni, Konstantina [VerfasserIn]
• Titel: Lung volume reduction with vapor ablation in the presence of incomplete fissures
• Titelzusatz: 12-month results from the STEP-UP randomized controlled study
• Verf.angabe: Daniela Gompelmann, Ralf Eberhardt, Maren Schuhmann, Arschang Valipour, Pallav L. Shah, Felix J.F. Herth, Konstantina Kontogianni
• E-Jahr: 2016
• Jahr: November 12, 2016
• Umfang: 7 S.
• Teil: volume:92
• Teil: year:2016
• Teil: number:6
• Teil: pages:397-403
• Teil: extent:7
• Fussnoten: Gesehen am 03.07.2020
• Titel Quelle: Enthalten in: Respiration
• Ort Quelle: Basel : Karger, 1944
• Jahr Quelle: 2016
• Band/Heft Quelle: 92(2016), 6, Seite 397-403
• ISSN Quelle: 1423-0356
• DOI: doi:10.1159/000452424
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1703447751

Abstract

<b><i>Background:</i></b> Emphysema patients with collateral ventilation (CV) will not benefit from valve therapy, the most common endoscopic lung volume reduction procedure. A recent randomized controlled trial (STEP-UP) of the alternative bronchoscopic thermal vapor ablation (BTVA) included patients with (CV+) and without interlobar CV (CV-). <b><i>Objectives:</i></b> This analysis evaluated the efficacy and safety of the CV+ population following BTVA. <b><i>Method:</i></b> A post hoc fissure analysis of the baseline computed tomography of all treatment and control patients was performed with the VIDA Diagnostics Apollo software. A patient was considered to be CV+ if either of the treated upper lobes was adjacent to a fissure that was <90% complete. The primary endpoints, forced expiratory volume in 1 s (FEV₁) and St. George's Respiratory Questionnaire (SGRQ-C), were calculated for these CV+ patients following BTVA and safety results summarized. <b><i>Results:</i></b> 78% (35/45) of the patients in the treatment arm and 79% (19/24) of the patients in the control arm were found to be CV+. At 12 months, the FEV₁ improvement of the treatment arm was 9.2%, as compared with a decrease of 5.4% in the control group, resulting in a mean between-group difference of 14.6% (<i>p</i> = 0.0137). The improvement in SGRQ-C of the treatment arm as compared to the control arm was 8.4 points (<i>p</i> = 0.0712). An increase in respiratory related serious adverse events was observed immediately following treatment, but most resolved with routine care. <b><i>Conclusion:</i></b> BTVA can achieve safe and clinically meaningful improvement in pulmonary function and quality of life in patients with CV. These randomized controlled trial subgroup results offer proof of a viable solution for CV+ patients.