Surgical Compared to Bronchoscopic Lung Volume Reduction in Patients With Severe Emphysema

Recruiting now · Not applicable

Conditions studied: Emphysema

In brief

The investigators plan to perform a randomized controlled trial that compares bilateral lung volume reduction surgery (LVRS) with bronchoscopic lung volume reduction (BLVR) using endobronchial valves in terms of efficacy and patient safety.

Key facts

Study ID

NCT04537182

Run by

Isabelle Opitz, Professor, MD

People needed

120

Starts

2020-09-01

Expected to finish

2028-03-01

Last updated by the study team

2024-05-08

Who can join

Age: 30 and older, up to 80. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patients suffering from emphysema (all morphologies, uni- or bilateral distribution) potentially qualifying for both study procedures, LVRS or BLVR (if possible, perfusion scintigraphy within < 6 month of screening, CT scan within < 4 months of screening)
• Age ≥ 30 and ≤ 80 years
• Body Mass Index (BMI) ≥ 16, but ≤ 35 kg/m2
• Non-smoking for 3 months prior to screening interview
• Patient is able to understand and willing to sign a written informed consent document.

You may not qualify if…

• FEV1 more than 50% predicted
• TLC less than 100 % predicted, RV less than 175% predicted, RV/TLC less than 58% predicted, and DLCO ≤ 20% predicted in homogeneous emphysema and DLCO ≤ 15% in heterogeneous emphysema, respectively
• PaO2 ≤ 6.0 kPa (45mm Hg) at ambient air (only applicable for homogeneous morphology!)
• PaCO2 ≥ 6.6 kPa (50 mmHg) at ambient air (only applicable for homogeneous morphology!)
• Patients with incomplete interlobar fissures as revealed by quantitative computed tomography analysis with StratX® (fissure completeness ≤ 80%)
• Patients with collateral ventilation as evidenced by bronchoscopic Chartis® measurement (only performed if fissure completeness according to StratX® is < 95%)
• 6-minute walking distance ≥ 470m
• More than two COPD exacerbation episodes requiring hospitalization in the last year
• More than two instances of pneumonia episodes in the last year
• Unplanned weight loss ≥ 10% within 90 days prior to enrollment
• Pulmonary hypertension as evidenced by Delta Psyst RV-RA > 35 mmHg on recent echocardiography (within 3 months prior to screening) and confirmed by RHC (mPAP ≥ 35 mmHg) and signs of moderate to severe RV dysfunction.
• Evidence of left ventricular ejection fraction (LVEF) less than 45% on recent echocardiography (within 3 months prior to screening)
• History of exercise-related syncope
• Myocardial infarction or congestive heart failure within 6 months of screening
• Clinically significant arrhythmias that might put the patient at risk in regard to the interventions
• Prior LVR (any method), bullectomy, or lobectomy
• Clinically significant bronchiectasis with expectoration of ≥ 2 tablespoons/day.
• Pulmonary nodule requiring surgery
• Unable to safely discontinue anticoagulants or dual antiplatelet therapy for 7 days
• Patients with a life expectancy of less than one year

Where it is running

• Universitätsklinik für Thoraxchirurgie, Medical University of Vienna — Vienna, Austria (enrolling)
• University Hospital Leuven — Leuven, Belgium (enrolling)
• Rigshospitalet, University of Copenhagen — Copenhagen, Denmark (enrolling)
• Kantonsspital Aarau — Aarau, Canton of Aargau, Switzerland (enrolling)
• Lausanne University Hospital (CHUV) — Lausanne, Canton of Vaud, Switzerland (enrolling)
• University Hospital Zurich, Division of Thoracic Surgery — Zurich, Canton of Zurich, Switzerland (enrolling)

Full record on ClinicalTrials.gov

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