Endobronchial coils

What are endobronchial coils?

Endobronchial coils are a treatment to improve breathing for patients who have severe emphysema. The coils are straightened to pass through your airways into the diseased parts of your lung. They are then released and gently curl back to their original shape. They gather up unhealthy lung tissue and hold open the airways to help you breathe more easily, feel better and be more active. Coils do not cure emphysema and breathing will still decline over time. About 1 in 5 people treated with coils do not find they help.

Coils are new so treatment is done alongside research to learn more about how they work, who benefits from coils and the longer term safety.

Can I have coils?

Before considering coils you would need to have a specialist assessment and tests. These include breathing tests, heart tests, walking tests and scans. These tests may need to be repeated throughout your assessment. You must have not smoked for at least 6 months and you must have completed a course of exercise.

If you are affected by any of the following coils are not suitable for you:

  • Allergy to nickel (the coils contain nickel)
  • Certain heart problems (pulmonary hypertension)
  • Taking medications to thin the blood, such as warfarin, if you are not allowed to stop them
What does the procedure involve?

The coils are put in selected airways of the lung using a thin flexible tube with a camera attached (bronchoscope).

This is performed under with you asleep under a general anaesthetic. Your surgeon will use X-rays to see where to place the coils. The coils are straightened to fit next to the flexible camera and then reform their coiled shape once they are released. Coils are designed to be a permanent implant.

About 10 coils will be placed in either in the upper or lower lobe of one lung, depending on your test results. The surgery takes 30 to 40 minutes. You will be monitored in the hospital for a few days before going home.

Most patients benefit more when both sides of the lung are treated. The treatment is done one side at a time with about 8 weeks in between.

What is recovery like?

After surgery you will be observed closely, you can eat and drink once you are fully awake. You will have an X ray to check the lungs.  You may have a sore throat but should not have pain after this. It is normal to feel tired for a number of days afterwards. You can start your normal activities once you go home. Please arrange for a responsible adult to come and pick you up from the hospital and take you home by car or taxi.

You may start to feel relief as soon as the very next day, but it may take a few weeks for you to feel benefit. Some people do not feel as much benefit as expected; research is ongoing to work out who will get the most benefit with coils.

During recovery, you may have extra coughing or flare ups of your emphysema, this is normal and usually resolves within about 30 days. If a flare up is severe or you are worried seek medical attention quickly.

Your breathing and walking tests will be repeated after treatment.

What are the risks?

The risks here are a guide; your own risk may vary. You should discuss the risks and benefits of surgery with your surgeon, especially if you are worried. Since you will already have severe lung disease the risks of an anaesthetic are higher.

  • Minor more common risks

You may feel feverish for a few hours after surgery and have a hoarse voice at first, these should settle. Air may escape from the lung and get into the space between the lung and the chest wall; this is called a pneumothorax (also known as a collapsed lung). If this occurs you will need to stay in hospital have a chest drain to remove the air. You may get a chest infection that requires treatment, including admission to hospital and cough up a small amount of blood.  You may notice an increase in mucous or wheezing, a flare up of your emphysema symptoms may happen that needs treatment. Chest pain after the treatment is also possible.

If you feel unwell or more short of breath after going home either contact us (during working hours) or attend your local emergency department.

What are the alternatives to surgery?

Most people with emphysema do not undergo coil treatment, the usual care for emphysema includes:

  • Not smoking
  • Exercise, classes for improving your lung function and learning more about the lungs are available across the country
  • Finding the right combination of medications (including inhalers) to suit you
  • Managing flare ups at home or with the help of your doctor
  • Healthy diet
  • Oxygen at home or ventilator machines

Even if you have coil treatment, you should continue this usual care with your hospital doctor and GP. It is your choice whether to go ahead with surgery or choose another kind of treatment. We will respect your wishes and support you in choosing the treatment that suits you. You are always welcome to seek a second opinion.