Pulmonary Coils

Patients with present a respiratory distress that can be very severe (dyspnea) and very limiting in the normal daily activity of the patient. It is an irreversible situation since there is a distention of the lung tissue that is not recoverable. The small airways (alveoli and bronchioles) lose their elastic retraction capacity with which the air is trapped during expiration, which becomes difficult, giving rise to what is known as hyperinflation. The clinic is usually progressive.

Tobacco is the main cause of emphysema. Common treatments include smoking cessation, respiratory physiotherapy and rehabilitation, bronchodilators, and drugs that improve breathing capacity. And for some years a technique for implantation of pulmonary coils (springs) in selected patients with severe emphysema. This treatment is already being carried out in several European countries, including Spain.

What are pulmonary coils?

Pulmonary coils are minimally invasive double-loop implants that are placed into the airway using a bronchoscope. They are made with a material called nitinol (nickel and titanium). The function of these pulmonary coils would be to keep the airways open by reducing air trapping, compress the affected areas of the lung, improving elasticity and favoring the patency of the airways.

How are they placed?

The coils are implanted through an endoscopic procedure. Generally, a number of 10 to 14 coils are initially implanted in one lung and after a couple of months it is carried out in the other lung. They are placed in the upper or lower lung lobes. Using a radiological technique (fluoroscopy), the correct implantation of the coils is confirmed. The intervention lasts about 40 minutes. General anesthesia or deep sedation is required. It is a not very aggressive and well tolerated treatment.

When would pulmonary coils be indicated?

This treatment would be indicated in patients with severe emphysema who present clinical worsening despite optimal medical treatment and regular monitoring by their pulmonologist.

What would be the benefits?

The improvement is not immediate, the patient may need several weeks to adapt to the treatment and notice the benefits. They have been seen to improve quality of life, lung function, and the ability to exercise in affected patients. Pulmonary coils or springs have been included in the current Gold 2107 Guidelines: International Medical Guidelines for the management of patients with chronic obstructive pulmonary disease) in the treatment of emphysema in selected patients.