{'fraction_non_alphanumeric': 0.051466519092418374, 'fraction_numerical': 0.027116768123962368, 'mean_word_length': 5.087542087542087, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Long-term follow-up after endoscopic valve therapy in patients with severe emphysema

Background: Endoscopic valve therapy is a treatment modality in patients with advanced emphysema and absent interlobar collateral ventilation (CV). So far, long-outcome following valve implantation was not evaluated. The aim of this trial was to investigate the efficacy of this interventional therapy over 3 years. Methods: From 2006-2013, 256 patients with severe emphysema in whom absent CV was confirmed underwent valve therapy. 3-year efficacy was evaluated by pulmonary function testing (VC, FEV1, RV, TLC), 6-minute-walk test (6-MWT) and dyspnoea questionnaires (mMRC). Long-term outcome was also assessed according to the radiological outcome following valve placement. Results: Of 256 patients, 220, 196, 175, 91 and 58 patients completed the 3-month, 6-month, 1-year, 2-year and 3-year follow-up (FU) visit, respectively. All lung function parameters, 6-MWT and mMRC were significantly improved at 3- and 6-month-FU. At 1-year FU, patients experienced still a significant improvement of VC (ml and %), FEV1 (ml and %), RV (ml and %), 6-MWT and mMRC. At 2 years, RV (ml and %) TLC (ml and %) remained significantly improved compared to baseline. Three years after valve therapy, sustained significant improvement in mMRC was observed and the proportion of patients achieving a minimal clinically important difference from baseline in RV and 6-MWT was still 73% and 44%, respectively. Overall, patients with complete lobar atelectasis exhibited superior treatment responses. Conclusions: Patients treated by valves experienced clinical improvement over one year. Afterwards, benefit gradually declines more likely due to COPD progression; nevertheless, a high proportion of patients are still clinical responders.