Long Term Efficacy and Safety of Bronchoscopic Thermal Vapor Ablation in Patients with COPD: A Retrospective Study of 50 Patients.

Background: Bronchoscopic Thermal Vapor Ablation (BTVA) has demonstrated improvements in FEV1 and quality of life in clinical trials. However, the long-term benefits and overall efficacy of this procedure remain uncertain and are not yet fully established. Methods: We conducted a retrospective observational study of all patients who underwent BTVA at Rabin Medical Center, Israel. The primary outcome was the change in FEV₁ from baseline. Secondary outcomes included other pulmonary function parameters and procedural adverse events. Results: A total of 50 patients were included in the study. The mean FEV1 values at baseline, 6 months, and 12 months post-procedure (n=31) were 0.74±0.21 L, 0.93±0.32 L, and 0.85±0.25 L, respectively (overall P<0.001; pairwise comparisons: baseline to 6 months, P<0.001; baseline to 12 months, P=0.016). The mean FVC values at baseline, 6 months, and 12 months post-procedure (n=31) were 1.97±0.56 L, 2.27±0.71 L, and 2.14±0.68 L, respectively (overall P=0.003; pairwise comparisons: baseline to 6 months, P=0.002; baseline to 12 months, P=0.125). Post-procedural complications included pneumonia in 5 patients (11%), of whom 3 developed necrotizing pneumonia and subsequently died, resulting in a 6% post-procedural mortality rate in the entire cohort. Hemoptysis was reported in 1 patient (2%). Conclusion: Bronchoscopic thermal vapor ablation is a minimally invasive bronchoscopic intervention for lung volume reduction. The procedure was associated with significant improvements in FEV₁ at 6 to 12 months and in FVC at 6 months, followed by a gradual decline over 12 to 24 months. Further research is warranted to optimize patient selection, enhance procedural safety, and assess long-term efficacy.