Pulmonary perfusion after endoscopic reduction of emphysema
Coils (RePneuÂ®) endoscopic lung volume reduction (ELVR) is a new promising approach for the treatment of severe emphysema.
Our goal was to analyze lung perfusion by iodine maps acquired with dual-energy CT scan (deCT) before and after coil implantation.
Among 14 included patients (62.8 Â± 9.0 yrs, IMC 22.0 Â± 3.5 kg.m-2), 4 already underwent 3 time points deCT with reconstruction of standard lung and perfusion images before and after bilateral treatment. Perfusion was analyzed objectively with measurements of iodine concentration (IC) for each lobe, and subjectively on the iodine maps.
The table shows patients characteristics. We observed a reduction of perfusion in the immediate proximity of the coils but a stability for the treated lobes (IC from 8.6 Â± 2.9 ug.cm-3 to 8.8 Â± 3.3). Whereas and interestingly, a clear trend toward increased perfusion was noted (IC from 11.0 Â± 3.7 to 13.5 Â± 7.6) in the non treated lobes (figure).
Lung functions before and after procedure.
ELVR by coils insertion seems to increase perfusion in the adjacent non-treated lobes, suggesting improved ventilation/perfusion relationship.