|
Post by gerald on Jan 24, 2017 14:12:20 GMT -5
It is excellent to see that followup study is being done to confirm long term affects and also to learn and improse. ------------------- Coil therapy for patients with severe emphysema and bilateral incomplete fissures – effectiveness and complications after 1-year follow-up: a single-center experience Background:
Lung volume reduction coil (LVRC) treatment is established in daily endoscopic lung volume reduction routine. The aim of this study was to evaluate the safety and efficacy of LVRC treatment. Patients and methods:
This was a retrospective analysis of 86 patients (male/female: 40/46, mean age: 64±7 years) with severe COPD and bilateral incomplete fissures. A total of 10 coils were unilaterally implanted in a single lobe, and 28 out of 86 patients were treated bilaterally. At 90-, 180-, and 365-day follow-up, changes in pulmonary function test (PFT), 6-minute walk test (6MWT) and modified Medical Research Council (mMRC) dyspnea scale, as well as possible complications, were recorded. Results:
At 90 days, the forced expiratory volume in 1 second did improve (P<0.001), but the improvement was not sustained at the 180- and 365-day follow-up (baseline: 0.71±0.21 vs 0.77±0.23 vs 0.73±0.22 vs 0.70±0.18 L). Both vital capacity and residual volume improved significantly (P<0.001) at the 90- and 180-day follow-up, but the improvement was lost after 365 days. Total lung capacity decreased at the 90-day follow-up but returned to baseline values at the 180- and 365-day follow-up. 6MWT (P=0.01) and mMRC (P=0.007) also improved at 90 and 180 days (Δ6MWT of 31±54 and 20±60 m, respectively), but the improvement was also lost at the 365-day follow-up. No significant further improvement was evident at any point in the follow-up after the second procedure. A total of 4 out of 86 patients passed away due to complications. Significant complications in the first 3 months and then at 12 months included the following: severe hemoptysis in 4 (3.5%) and 4 (3.5%) patients, pneumonia requiring hospitalization in 32 (28.1%) and 9 (7.9%) patients and pneumothorax in 7 (6.1%) and 2 (1.7%) patients, respectively. Milder adverse events included self-limited hemoptysis, pneumonias, or COPD exacerbations treated orally. Conclusion: LVRC improved PFT, 6MWT and mMRC initially, but the improvement was lost after 365 days. Furthermore, we observed 4 deaths and significant severe complications, which need to be further elucidated. www.dovepress.com/coil-therapy-for-patients-with-severe-emphysema-and-bilateral-incomple-peer-reviewed-article-COPD
|
|
|
Post by John on Jan 25, 2017 7:27:19 GMT -5
Thanks Gerald something to think about
|
|
|
Post by gerald on Jan 25, 2017 15:20:17 GMT -5
They never have claimed that coils would lengthen life, only that they would improve quality of life.
It appears the coils do improve quality of life for a time, it is unfortunate that they effect only lasts 1-2 years.
At least this study provides people more information upon which to make a decision.
|
|
|
Post by ozboy on Apr 19, 2017 7:10:02 GMT -5
Current copy and paste report from my friend in the UK who has done the Nitinol Coil Trial.
............................................................................................................................................
FEB. 19th. 2017 I've been so enjoying the honeymoon period of increased capability and energy since my lung coils operation two weeks ago that the arrival of a couple of 'bad' days quite blindsided me. Yesterday and today found me back in the familiar cycle of breathlessness, short recovery and breathlessness again - boom and bust, some call it. A bit depressing, but then I did a bit of self evaluation - still blowing much more than I used to on my peak flow meter, O2 stats well up at 97 - and asked myself ' would I have still gone to the gym, walked to the bakery, instead of taking the car on a 'bad' day?' Certainly not. I probably wouldn't have even left the house. I know now that there are still going to be good and bad days but the bad days are not going to be as bad as before. I think it has also been a bit of a worry to those around me who have seen me so much better and then all of a sudden struggling again. I've had to take time out to explain to them that while the operation (still only half completed after all - one lung still to do on March 1 - has been a godsend, a leg-up and a second chance, it is by no means a cure.
FEB. 22nd. After four or five days of increased, and sometimes quite severe, breathlessness I finally went back to see the doctor who had facilitated my lung coils operation three weeks ago. My greatest fear was that something had gone wrong with the procedure itself, but an x-ray showed that all coils were still in position, there had been no lung tissue tearing, no sign of anything anatomically wrong. He listened to my chest, checked O2 saturation, temperature, and took a blood sample. I hung around the hospital – I was there anyway for my regular Singing for Breathing class – for the results. Upshot is that I’m probably having an exacerbation, unrelated to the procedure, but serious enough for them to delay the second half of the process – inserting coils into the other lung - for about a month. I’m back on steroids (lower dose, longer course) and antibiotics. Naturally I’m disappointed by events – and by the delay - but I have most certainly not lost faith in my doctors or the procedure itself . The four or five days of increased capacity and energy I enjoyed before the breathlessness came on are proof enough to me of its value. All in all I’m not downhearted and, in fact, slightly relieved that there’s nothing fundamentally wrong.
MARCH 9th. After four or five days of increased, and sometimes quite severe, breathlessness I finally went back to see the doctor who had facilitated my lung coils operation three weeks ago. My greatest fear was that something had gone wrong with the procedure itself, but an x-ray showed that all coils were still in position, there had been no lung tissue tearing, no sign of anything anatomically wrong. He listened to my chest, checked O2 saturation, temperature, and took a blood sample. I hung around the hospital – I was there anyway for my regular Singing for Breathing class – for the results. Upshot is that I’m probably having an exacerbation, unrelated to the procedure, but serious enough for them to delay the second half of the process – inserting coils into the other lung - for about a month. I’m back on steroids (lower dose, longer course) and antibiotics. Naturally I’m disappointed by events – and by the delay - but I have most certainly not lost faith in my doctors or the procedure itself . The four or five days of increased capacity and energy I enjoyed before the breathlessness came on are proof enough to me of its value. All in all I’m not downhearted and, in fact, slightly relieved that there’s nothing fundamentally wrong.
APRIL 11th.
An update on my Lung Coils saga. Some of you may know that I had ten coils put in my right (the most badly afflicted) lung on Feb 1 at the Brompton Hospital, London as part of a clinical trial which I had laboured long and hard to get a place on. After three or four days recovering from the procedure (sore chest, SOB, generally weak) I enjoyed slightly less than a week of greatly increased energy, capacity and general well-being. Since then I’ve been suffering severe SOB episodes, sometimes on only very slight exertion and, even after nine weeks, am not significantly improving. I’ve had three rounds of tests – observational, x-ray, ECG and blood tests, and once a CT scan to make sure that I hadn’t developed a blood clot. I’ve had a week of high dose prednisolone and a longer period of low dose. Tomorrow they are going to repeat a full set of pulmonary function tests. It’s all a bit puzzling, and to be honest a worry and disappointment. I had expected to be something like 25% better after the procedure (and indeed was, for the first week) instead I find myself at around 75% of my previous capacity. There’s nothing wrong with my heart, no sign of infection, O2 stats are good and PF (as measured by my little peak flow meter) has improved since the procedure. The coils are in place and appear to be doing thier job of reducing hyperinflation.There is just this constant debilitating series of SOB episodes. I get excellent personal attention from a very bright doctor doing his PhD at the hospital. He’s talked with the consultant surgeon (a well-respected expert in this field) and, although not yet confirmed, it seems like they are thinking that we should go ahead with the other lung, when I will feel the full benefits of the procedure. In spite of the setbacks I still have confidence in both my doctors and the theory behind the procedure and don’t believe they would suggest this if there was any cause to suspect it would do me harm. Friends and family are supportive of me going ahead. Nevertheless, if and when I do it, it will be with some feelings of anxiety and trepidation, rather than the boundless optimism I felt when the first lung was done. ==============================================
He decided to go and get the other lung done....He is a great guy and worked very hard....I also have a close friend that lives near me in Melb....He had the Bronchial Valves (BLVR) done in Jan 2016 Out of trial so paid a lot of money after Medicare paid normal hospital costs etc...He ended up in a really bad way and regrets having them done..As of yet I only briefly accidently met another lady in Aust. She is doing ok but says it has done nothing much and needs the valves replaced but cannot afford them.....
|
|