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. 2013:2013:361391.
doi: 10.1155/2013/361391. Epub 2013 Apr 23.

Severe Emphysema Treated by Endoscopic Bronchial Volume Reduction with Lung Sealant (AeriSeal)

R F Falkenstern-Ge  1 , H Ingerl, M Kohlhäufl
Affiliations

Severe Emphysema Treated by Endoscopic Bronchial Volume Reduction with Lung Sealant (AeriSeal)

R F Falkenstern-Ge et al. Case Rep Pulmonol. 2013.

Abstract

Endoscopic lung volume reduction using lung sealant is a very new and innovative treatment option for patients with severe progressive and irreversible lung emphysema. A 55-year-old ex-smoker (60 pack years) referred to our center because of severe lung emphysema with progressive worsening of the obstructive ventilator pattern and clinical condition. We detected collateral channels of this patient by using the Chartis system. Therefore, we decided to treat the advanced emphysema of our patient with endoscopic volume reduction using lung sealant (AeriSeal). The foam of lung sealant AeriSeal is instilled into the peripheral airways and alveoli where it polymerizes and functions as tissue glue on the lung surface in order to seal the target region to cause durable irreversible absorption atelectasis. The follow-up evaluation 12 weeks later showed improved lung function (increased FEV 1/partial oxygen pressure/peripheral oxygen saturation and a reduction of TLC and RV) with improved quality of life. Correlation between changes in primary and secondary outcome measures in the lung function parameters and 6-minute-walking test before and 12 weeks after the application of lung sealant revealed significant reduction of hyperinflation and improvement both in the flow rates and in the physical capability of this patient.

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Figures

Figure 1
Figure 1
(a) Chest X-ray 4 weeks before the endoscopic lung volume reduction. (b) Chest X-ray 3 days after the endoscopic lung volume reduction shows atelectasis of both right and left upper lobe after endoscopic lung volume reduction.
Figure 2
Figure 2
(a). CT scan 4 weeks before the intervention of endoscopic lung volume reduction revealed severe heterogeneous centrilobular lung emphysema with bilateral involvement of the upper lobes. (b) CT scan 3 days after the intervention of AeriSeal revealed the induced atelectasis of the bilateral upper lobes.
Figure 3
Figure 3
(a) AeriSeal foam sealants fill the targeted region of right upper lobe segment 2. (b) AeriSeal foam sealants fill the targeted region of left upper lobe segment 2.
See this image and copyright information in PMC

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