Efficacy of bronchoscopic thermal vapor ablation in patients with heterogeneous emphysema and lobar quantification by three-dimensional ventilation/perfusion single-photon emission computed tomography/computed tomography: a prospective pilot study from China

Zhu, Weiming; Zhang, Yuchen; Herth, Felix J.F.; Liú, Dan; Zhou, Hui; Shi, Jingyu; Zhang, Chujie; Tang, Gongshun; Luo, Fengming

doi:10.1097/cm9.0000000000002013

Cited by 3 publications

(2 citation statements)

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“…The ceiling effect and differential contribution of small airways disease versus emphysema may be the explanation which lead to GOLD stage III patients having more regions of the lung that can have compensatory hyperinflation [ 31 ], which may be in agreement with our results. Despite of a numerical difference in the magnitude of effectiveness was observed from 3 to 12 months [ 14 – 17 , 21 , 25 ], BTVA was an available and well tolerated procedure for a great number of patients which are excluded from surgery or EBV for clinical issue.…”

Section: Discussionmentioning

confidence: 99%

Impact of bronchoscopic thermal vapor ablation on lung volume reduction in patients with emphysema: a meta-analysis

Zhi,

Liao,

et al. 2023

BMC Pulm Med

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Background Bronchoscopic lung volume reduction (LVR) could significantly improve pulmonary function and quality of life in patients with emphysema. We aimed to assess the efficacy and safety of bronchoscopic thermal vapor ablation (BTVA) on LVR in patients with emphysema at different stage. Methods A systematic search of database including PubMed, Embase and Cochrane library was conducted to determine all the studies about bronchoscopic thermal vapor ablation published through Dec 1, 2022. Related searching terms were “lung volume reduction”, “bronchoscopic thermal vapor ablation”, “bronchial thermal vapor ablation” “BTVA” and “emphysema”, “efficacy” and”safety”. We used standardized mean difference (SMD) to analyze the summary estimates for BTVA therapy. Results We retrieved 30 records through database search, and 4 trials were selected for meta-analysis, including 112 patients with emphysema. Meta-analysis of the pooled effect showed that levels of forced expiratory volume in 1 s (FEV1), residual volume (RV), total lung capacity (TLC), 6-min walk distance (6MWD) and St George’s Respiratory Questionnaire (SGRQ) were significantly improved in patients with emphysema following BTVA treatment between 6 months vs. baseline. Additionally, no significant changes in FEV1, RV, TLC and SGRQ occurred from 3 to 6 months of follow-up except for 6MWD. The magnitude of benefit was higher at 3 months compared to 6 months. The most common complications at 6 months were treatment-related chronic obstructive pulmonary disease (COPD) exacerbations (RR: 12.49; 95% CI: 3.06 to 50.99; p < 0.001) and pneumonia (RR: 9.49; 95% CI: 2.27 to 39.69; p < 0.001). Conclusions Our meta-analysis provided clinically relevant information about the impact and safety of BTVA on predominantly upper lobe emphysema. Particularly, short-term significant improvement of lung function and quality of life occurred especially within the initial 3 months. Further large-scale, well-designed long-term interventional investigations are needed to clarify this issue.

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Section: Discussionmentioning

confidence: 99%

Impact of bronchoscopic thermal vapor ablation on lung volume reduction in patients with emphysema: a meta-analysis

Zhi,

Liao,

et al. 2023

BMC Pulm Med

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“…64 A more recent pilot study in China evaluated the feasibility of lobar quantification using 3D ventilation/perfusion (V/Q) single-photon emission computed tomography (SPECT/CT) to assess regional effects after BTVA. 65 This was a small study in which patients were treated with one or two BTVA sessions after which five had a 3D V/Q SPECT/CT that confirmed a shift in ventilation and perfusion between ipsilateral treated and nontreated lobes.…”

Section: Bronchoscopic Thermal Vapor Ablationmentioning

confidence: 94%

Developing Interventions for Chronic Obstructive Pulmonary Disease

Schwalk,

Patel,

Madisi

2024

Semin Respir Crit Care Med

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Chronic obstructive pulmonary disease (COPD) is an incurable, progressive respiratory disease that may have a significant negative impact on the morbidity and mortality of affected patients. A substantial portion of the world's population is affected by COPD, and despite optimal medical management with medications, supplemental oxygen, and pulmonary rehabilitation, many patients are left debilitated because of this disease. Bronchoscopic treatment modalities offer a less-invasive method for the treatment of refractory COPD compared to surgical interventions and have expanded the potential therapeutic options for these patients. Bronchoscopic lung volume reduction is aimed at decreasing the hyperinflation and air trapping that occur in emphysema, and the most studied and successful intervention is endobronchial valve placement. Endobronchial coils, polymeric sealants, and thermal ablation are other researched alternatives. Additional interventional procedures are being investigated for the treatment of the mucus hypersecretion and cough that are associated with the chronic bronchitis phenotype of COPD and include targeted lung denervation, metered dose spray cryotherapy, deobstruction balloon, and bronchial rheoplasty. This review summarizes the most recent evidence pertaining to available therapies for the management of COPD, including chronic bronchitis, with a particular focus on bronchoscopic interventions.

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Challenges in clinical practice, biological mechanism and prospects of physical ablation therapy for COPD

Zhu,

Zhou,

et al. 2024

Life Sciences

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Efficacy of bronchoscopic thermal vapor ablation in patients with heterogeneous emphysema and lobar quantification by three-dimensional ventilation/perfusion single-photon emission computed tomography/computed tomography: a prospective pilot study from China

Abstract: University (Ethical approval No. 2019533). Written informed consent was provided prior to partici-Wenjun Zhu and Yuchen Zhang contributed equally to this work.

Cited by 3 publications

References 5 publications

Impact of bronchoscopic thermal vapor ablation on lung volume reduction in patients with emphysema: a meta-analysis

Impact of bronchoscopic thermal vapor ablation on lung volume reduction in patients with emphysema: a meta-analysis

Developing Interventions for Chronic Obstructive Pulmonary Disease

Challenges in clinical practice, biological mechanism and prospects of physical ablation therapy for COPD

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