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Bronchoscopic lung volume reduction with one-way endobronchial valves (EBV) is a proven treatment option for usual chronic obstructive pulmonary disease (COPD) patients with advanced emphysema. This minimal invasive technique has been shown to improve clinical outcomes, especially in patients limited by severe hyperinflation in the absence of collateral ventilation. EBV is currently not a guideline treatment in AATD emphysema, and safety and feasibility in this subgroup remains largely unknown.
Retrospective explorative descriptive study performed in the EARCO registry . Clinical data will be collected, especially data guiding in selecting patients for EBV, such as symptoms & limitations (mMRC, CAT, 6MWD), spirometry, diffusion capacity, bodyplethysmography (RV/TLC), co-morbidities (exacerbation frequency, arterial blood gas, cardiovascular disease) and data from CT scan: heterogenous vs homogenous emphysema, potential target lobe, fissure completeness and to verify exclusion criteria for EBV.
We will also compare pre and post EBV insertion data for EARCO patients who have undergone EBV placement. This will include comparison of lung function, QoL metrics and 6MWT. We will contact individual EARCO study sites and collect additional data on rates of removal, replacement and complications of EBV where necessary.
Percentage of AATD patients suitable for EBV and rates of EBV referral will be compared to non-AATD COPD from published studies to address our research questions.