Insertion of endobronchial nitinol coils to improve lung function in emphysema

3 The procedure

3.1 Insertion of endobronchial nitinol coils is intended to be a minimally invasive alternative to lung volume reduction surgery. The procedure reduces the volume of diseased areas of the lungs. This minimises airflow to the least functional diseased lung segments, allowing air to flow to healthier parts of the lungs, with the aim of improving gas exchange and, as a result, lung function. The procedure is intended to improve lung function in patients with upper or lower lobe heterogeneous emphysema, as well as in patients with multiple emphysematous lobes with focal tissue defects.

3.2 Endobronchial nitinol coils can be inserted with the patient under general anaesthesia or sedation. The bronchial tree of the diseased area of the lung is visualised by bronchoscopy and a low‑stiffness guidewire is advanced through the bronchoscope under fluoroscopic guidance. A catheter is then passed over the guidewire. The guidewire is removed and a straightened coil is introduced through the catheter. The catheter is withdrawn while the coil is held in place using a grasper. When released, the straightened coil springs back to a predetermined shape, pulling on the surrounding diseased tissue and reducing lung volume. Typically, 5 to 15 coils are inserted in each treated lobe and each lung is treated in separate procedures. The coils are intended to remain in place permanently.