Bronchoscopic lung volume reduction by endobronchial valve in advanced emphysema: the first Asian report

Purpose: Endobronchial valve (EBV) therapy is increasingly being seen as a therapeutic option for advanced emphysema, but its clinical utility in Asian populations, who may have different phenotypes to other ethnic populations, has not been assessed. Patients and methods: This prospective open-label single-arm clinical trial examined the clinical efficacy and the safety of EBV in 43 consecutive patients (mean age 68.4 ± 7.5, forced expiratory volume in 1 second [FEV 1 ] 24.5% ± 10.7% predicted, residual volume 208.7% ± 47.9% predicted) with severe emphysema with complete fissure and no collateral ventilation in a tertiary referral hospital in Korea. Results: Compared to baseline, the patients exhibited significant improvements 6 months after EBV therapy in terms of FEV 1 (from 0.68 ± 0.26 L to 0.92 ± 0.40 L; P , 0.001), 6-minute walk distance (from 233.5 ± 114.8 m to 299.6 ± 87.5 m; P = 0.012), modified Medical Research Council dyspnea scale (from 3.7 ± 0.6 to 2.4 ± 1.2; P , 0.001), and St George’s Respiratory Questionnaire (from 65.59 ± 13.07 to 53.76 ± 11.40; P = 0.028). Nine patients (20.9%) had a tuberculosis scar, but these scars did not affect target lobe volume reduction or pneumothorax frequency. Thirteen patients had adverse events, ten (23.3%) developed pneumothorax, which included one death due to tension pneumothorax. Conclusion: EBV therapy was as effective and safe in Korean patients as it has been shown to be in Western countries. (Trial registration: ClinicalTrials.gov: NCT01869205).

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