Referring to the COPD Clinic
Advanced Care for Patients with COPD
The Chest Disease Center’s COPD Clinic provides multidisciplinary evaluation and treatment of patients with advanced chronic obstructive pulmonary disease (COPD). The multidisciplinary COPD Clinic team includes interventional pulmonologists, thoracic surgeons, pulmonologists, and other health care providers throughout BIDMC.
The COPD Clinic’s services include: Pulmonary rehabilitation, smoking cessation, medical therapy, Alpha-1-Antitrypsin replacement, endoscopic lung volume reduction, bullectomy, and referrals for lung volume reduction surgery and lung transplantation.
We are also actively involved in several clinical trials.
For an introduction to all of the services provided by the Interventional Pulmonary Service at our Chest Disease Center, please see our brochure.
Is Endobronchial Lung Volume Reduction (eLVR) appropriate for your patient?
Endoscopic lung volume reduction with placement of endobronchial valves is a new FDA approved treatment of severe emphysema. This minimally invasive bronchoscopic approach to lung volume reduction provides an alternative to surgical procedures.
The LIBERATE trial, Criner et al, 2018 was the first large randomized controlled, multicenter, international study conducted in patients with severe heterogeneous emphysema with no collateral ventilation which showed improvement in FEV1, exercise capacity, and quality of life following placement of endobronchial valves and subsequent lobar collapse.
We are happy to speak to you in person about your patient’s candidacy. Please contact us by email or call 617-632-8252.
Generally, the following criteria must be met for consideration of eLVR:
- Severe heterogeneous and homogenous emphysema on chest CT scan
- Stable disease with </= 20 mg Prednisone daily
- Full PFTs (including volumes) within past 6 months with evidence of hyperinflation RV <150%
- FEV1 15% > 45% predicted
- Tobacco abstinence for 4 months
- Lung nodule that has not been proven to be stable for >2 years
- PaCO2 >/= 60mmHg, PaO2 </= 45mmHg on room air
- Known allergy to Nitinol, Nickel, Titanium or Silicone
- Large bullae >30% of either lung