Successful Bronchoscopic Lung Volume Reduction with New Lung Tensioning Device Coil: A Case Report

Abstract

<b><i>Introduction:</i></b> Bronchoscopic lung volume reduction (BLVR) using endobronchial coil treatment is a widely studied therapeutic option in patients with end-stage chronic obstructive pulmonary disease (COPD) and pulmonary emphysema. However, patient responses were inconsistent, and, from 2020, production discontinuation rendered the treatment unavailable. In the meantime, a next-generation lung tensioning coil (FreeFlow Coil 4; FreeFlow Medical, Inc., Fremont, CA, USA) has been developed by the inventor of the lung volume reduction coil implant technology. This case study presents the first documented successful BLVR using FreeFlow Coils 4. <b><i>Case Presentation:</i></b> A 68-year-old male patient with COPD, classified as Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3, and homogenous emphysema with incomplete interlobar fissures was treated using the new developed FreeFlow Coil 4 in both upper lobes. Apart from a suspected coil-associated opacity, no adverse events occurred. At the 18-week follow-up, a significant improvement in lung function and quality of life was observed, as measured by forced expiratory volume in 1 s (+150 mL), residual volume (−0.50 L), 6-min walking distance (+75 m), and the total score of the St. George’s Respiratory Questionnaire (SGRQ) (−35 points). <b><i>Conclusion:</i></b> BLVR with FreeFlow Coils 4 has shown promising outcomes, significantly improving both pulmonary function and quality of life in 1 patient. However, larger studies and randomized controlled trials are imperative to investigate the efficacy and safety profile of the new coil system.