Efficacy and safety of simultaneous combined Zephyr and Spiration valve therapy in patients with advanced pulmonary emphysema

• Verfasst von: Dittrich, A. Susanne [VerfasserIn]
• Verfasst von: Kontogianni, Konstantina [VerfasserIn]
• Verfasst von: Unterschemmann, Ann-Sophie [VerfasserIn]
• Verfasst von: De Rossi, Susanne [VerfasserIn]
• Verfasst von: Trudzinski, Franziska [VerfasserIn]
• Verfasst von: Brock, Judith [VerfasserIn]
• Verfasst von: Gompelmann, Daniela [VerfasserIn]
• Verfasst von: Heußel, Claus Peter [VerfasserIn]
• Verfasst von: Herth, Felix [VerfasserIn]
• Verfasst von: Eberhardt, Ralf [VerfasserIn]
• Titel: Efficacy and safety of simultaneous combined Zephyr and Spiration valve therapy in patients with advanced pulmonary emphysema
• Verf.angabe: A. Susanne Dittrich, Konstantina Kontogianni, Ann-Sophie Unterschemmann, Susanne De Rossi, Franziska Trudzinski, Judith Maria Brock, Daniela Gompelmann, Claus Peter Heussel, Felix J.F. Herth, Ralf Eberhardt
• E-Jahr: 2024
• Jahr: November 2024
• Umfang: 8 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 3. August 2024, Artikelversion: 21. August 2024 ; Gesehen am 07.10.2024
• Titel Quelle: Enthalten in: Respiratory medicine
• Ort Quelle: Burlington, Mass. : Harcourt, 1999
• Jahr Quelle: 2024
• Band/Heft Quelle: 233(2024) vom: Nov., Artikel-ID 107760, Seite 1-8
• ISSN Quelle: 1532-3064
• DOI: doi:10.1016/j.rmed.2024.107760
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Chronic obstructive lung diseases
• Sach-SW: Emphysema
• Sach-SW: Endobronchial valve
• Sach-SW: Intrabronchial valve
• Sach-SW: Lung volume reduction
• Sach-SW: Spiration
• Sach-SW: Zephyr
• K10plus-PPN: 1904921450

Abstract

Background - Endoscopic lung volume reduction with valves is a minimally invasive treatment strategy for patients with severe pulmonary emphysema. Two valve systems are currently available: Zephyr and Spiration valves. As these can be implanted simultaneously in the same procedure, the question arose as to the effect on lung function, exercise capacity and subjective disease perception after combined valve treatment. - Methods - We conducted a retrospective analysis of 108 patients with combined, simultaneous treatment of Zephyr and Spiration valves. The decision on which and how many valves to implant was based on the individual patient anatomy. Effects on lung function, exercise capacity and atelectasis formation as well as complications were evaluated 90- and 180-days post-treatment (90d-FU and 180d-FU). - Results - At 90d-FU (n = 90), the mean change was 86.7 ± 183.7 mL for FEV1 and -645.3 ± 1276.5 mL for RV, with responder rates of 39.8 % and 46.5 %, respectively. Complete atelectasis occurred in 16.7 % and partial atelectasis in 25.5 % of patients. Six-minute walking distance increased by 27.00 m [-1.50 - 68.50m]. The rates of pneumothorax (10.2 %) 6 months after treatment were not higher than in randomized controlled trials (RCTs). Likely due to the inclusion of high-risk patients, there was a higher incidence of severe COPD exacerbation (21.3 %) and pneumonia (12.0 %) compared to RCTs. - Conclusions - The combined implantation of Zephyr and Spiration valves resulted in significant clinical and functional improvements with an acceptable risk profile. Therefore, the ability to combine both valve types in severe emphysema could be a promising option in endoscopic lung volume reduction.