Abstract
BACKGROUND AND OBJECTIVE: Bronchoscopic Thermal Vapor Ablation (BTVA) is a novel endoscopic lung volume reduction (ELVR) technique designed to target emphysematous segments and reduce lung hyperinflation, especially in patients with heterogeneous emphysema. Although previous studies have demonstrated its efficacy in Western populations, data regarding BTVA outcomes in Asian cohorts remain limited. This study aimed to evaluate the short-term efficacy and safety of BTVA in patients with severe COPD in a real-world clinical setting. METHODS: This single-center, retrospective, observational study included 8 patients with advanced COPD who underwent BTVA at the Eighth Affiliated Hospital of Sun Yat-sen University between May 2023 and December 2024. Pulmonary function (FEV(1), FVC, FEV(1)/FVC), 6-minute walk distance (6MWD), dyspnea scores (mMRC, CAT), and CT-based lung volume changes were assessed at baseline and at 1, 3, and 6 months post-treatment. Procedure-related adverse events were monitored for 1 month, and all patients were followed up for 6 months. RESULTS: All patients completed the 6-month follow-up. Significant improvements in FEV(1), FVC, 6MWD, and clinical symptoms (CAT and mMRC) were observed as early as 1 month post-BTVA and were sustained through 6 months. Although FEV(1)/FVC showed no statistically significant change at 1 and 3 months, a significant increase was detected by month 6. CT imaging at 6 months revealed a marked reduction in the targeted lung volume from 707.5 ± 115.74 mL to 335.5 ± 129.59 mL. No severe adverse events were reported. CONCLUSION: BTVA appears to be a safe and effective minimally invasive intervention for selected patients with advanced COPD, leading to significant short-term improvements in lung function, exercise capacity, and hyperinflation. These findings support the clinical utility of BTVA in Asian populations, although larger prospective studies are needed to confirm long-term benefits and assess repeatability.