Coil Treatment

Do you suffer from severe emphysema and especially severe breathlessness? Have you already been treated with numerous medications and received various therapies?

Coil Treatment is one option that could relieve your symptoms and help you to breathe easier.


How do Coils Work?

Endobronchial Coils are permanently implanted in the most damaged parts of the lung. The Coils are designed to gather and compress damaged lung tissue and increase elastic recoil, allowing the lungs to more efficiently contract during the breathing cycle. The unique shape of the Coils helps to hold open the small airways that can collapse (as a result of tissue damage) when the patient breathes out. This action reduces air trapping and hyperinflation while redirecting air to healthier portions of the lung1.


How is the Coil Procedure Performed?

After careful screening by your medical pulmonologist in collaboration with the pulmonologist in the treatment center and with your consent to proceed, you will be scheduled for your first endobronchial Coil procedure. Treatment with endobronchial Coils is usually performed in two procedures, one to treat each lung. The second procedure normally takes place 1-3 months after the first one. On the day of the procedure, you will check into the Interventional Bronchoscopy area of the hospital. The hospital staff will prepare you for your endobronchial Coil procedure per standard hospital practice. The procedure can be carried out in general anesthesia or procedural sedation and analgesia.

Using a bronchoscope and dynamic x-ray, the coils are placed in the small airways of the chosen lung area. Each treatment lasts 35 to 45 minutes. The treatment is followed by a short hospital stay.


Coil implantation

During the procedure, each individual Coil is temporarily straightened using specially-designed medical instruments. Coils are introduced into the lung in their stretched-out form using a bronchoscope.
After implantation, they return to their original Coil shape.
Your doctor will implant the Coils, one by one, until enough Coils are implanted.
On average, 10 to 12 Coils are placed in the upper lobe and 10 to 14 Coils in the lower lobe.
When implanted in the airways, Coils are designed to gather and compress damaged lung tissue, re-tensioning the airway network to mechanically increase elastic recoil in the emphysematous lung.

This action may reduce airway collapse and air trapping, while redirecting air to healthier portions of the lung.1 This should especially alleviate breathlessness upon exertion, for example when exercising.
The improved elastic recoil helps to reduce hyperinflation, thereby allowing the diaphragm to function better.

What to Expect After Coil Treatment?

Studies and clinical practice have shown that the quality of life and the exercise capacity can improve after Coil treatment. (Quality of life was assessed using the St. George’s Respiratory Questionnaire, a well-known and standardized method and exercise capacity is measured with 6MWT).

In some cases, significant improvement of the symptoms occurs only after the treatment of the second lung.

According to experience, patients are released after a short hospital stay. However, in spite of the greatest care, this treatment can lead to complications in rare cases. These will be discussed with the doctor in your medical briefing before the treatment.

Generally the second procedure is performed 1-3 months after the first Coil procedure.


What are the Risks of the Coil Procedure?

As with any medical procedure, there are risks and complications associated with the bronchoscopy procedure, as well as with endobronchial Coil treatment.

Some patients may experience a sore throat, a slight cough, wheezing or shortness of breath for a few days after the Coil procedure. Some patients may cough up pink colored sputum or small amounts of blood.

Some patients have experienced temporary worsening of their COPD or pneumonia after treatment. Some patients have also experienced an inflammatory response in their lungs, in the area surrounding the Coils, with symptoms very similar to pneumonia. Unlike pneumonia, this condition is not an infection, is often mild and is usually treated with medicine. In some cases however, the condition may be serious enough to require immediate medical attention.

Infrequently, more severe problems may occur after Coil treatment, such as severe respiratory infection, pneumothorax, severe hemoptysis, or respiratory failure. In rare cases, some of these severe problems can result in death.

Your doctor will talk to you about both the risks and the benefits of endoscopic treatment with Coils.

For additional risk information, click here.


What are the Benefits of the Coil Procedure?

Coils have been shown to be safe and effective in patients with severe emphysema (heterogeneous and/or homogeneous). Many patients who have had both lungs treated with endobronchial Coils experienced improvement in their quality of life, lung function, and exercise capacity.2-7 Your results may be different, depending on your condition and the treatment you receive.

1 RePneu™ (Lung Volume Reduction) Coil System Instructions For Use (LBL0139)
2 Klooster K, Ten Hacken NHT, Franz I, et al. Lung Volume Reduction Coil Treatment in Chronic Obstructive Pulmonary Disease Patients with Homogeneous Emphysema: A Prospective Feasibility Trial. Respiration 2014; DOI: 10.1159/000362522
3 Deslée G, Mal H, Marquette CH,et al. Lung Volume Reduction Coil Treatment vs Usual Care in Patients With Severe Emphysema. The REVOLENS Randomized Clinical Trial, JAMA. 2016; DOI:10.1001/jama.2015.17821
4 Shah PL, Zoumot Z, Singh S, et al. Endobronchial coils for the treatment of severe emphysema with hyperinflation (RESET): A randomised controlled trial. Lancet Respir Med 2013; DOI: 10.1016/S2213-2600(13)70047-X
5 Slebos DJ, et al. Bronchoscopic Coil Treatment for Patients with Severe Emphysema: A Meta-Analysis. Respiration 2015; DOI: 10.1159/000431384
6 Hartman JE, et al. Long-term follow-up after bronchoscopic lung volume reduction treatment with coils in patients with severe emphysema. Respirology 2014; DOI: 10.1111/resp.12435
7 Sciurba FC, Criner GJ, Strange C, et al. Effect of endobronchial coils vs usual care on exercise tolerance in patients with severe emphysema: The RENEW Randomized Clinical Trial. JAMA 2016 ; DOI:10.1001/ jama.2016.6261.