Bronchoscopic Thermal Vapor Ablation (BTVA) in patients with severe upper lobe predominant emphysema: 36 months follow-up results from a prospective registry

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Background: Targeted BTVA can lead to lung volume reduction. Previous data from a prospective RCT demonstrated lung function (PFTs) and quality of life improvements. This study looks at the longer-term effects of BTVA with regard to PFTs, exercise capacity, and QoL from an ongoing international registry. Methods: Data from 10 clinical sites were analysed. Measurements included FEV1, RV, 6-MWT and SGRQ prior to treatment and up to 36months (M) later. 204 treated patients (age 64.4 ± 6.81 yrs; FEV1 30.2 ± 8.33 % pred) undergoing 314 BTVA procedures from 05/2017 to 01/2023 were included. Missing data were not inputed. Results: Of the 204 patients, 116 underwent 12M-Follow-up (FU), 63 24M-FU, and 42 patients 36M-FU. In a total of 314 BTVA procedures, 97 procedure-related serious adverse events (SAEs), amongst them 26 COPD exacerbations, 30 pneumonias, 6 haemoptysis, were reported. 28 out of a total of 46 severe SAEs resolved without sequelae. Statistically significant improvements for SGRQ and RV were observed at 12M (SGRQ, RV) and 24M (SGRQ). Changes in FEV1 and 6-MWT did not achieve statistical significance. Conclusions: FU of patients treated with BTVA in a real-world cohort. The data show safety and improvements in some COPD outcomes at 12M and 24M, however, waning treatment effects during longer-term FU.

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