Even though eLVR with EBV is an established therapy option for patients with severe emphysema, patients with hypercapnic respiratory failure are usually excluded from treatment. We retrospectively evaluated all patients treated in our department. Hypercapnic respiratory failure was defined as CO 2 ≥ 50mmHg and/or NIV therapy. All patients underwent V/Q-Scan and were evaluated for collateral ventilation (Chartis) to determine the target lobe. CO 2 was analyzed at 3 time points (TP), before, 2-4 days after, and 1-3 months after eLVR. We treated 13 patients (6 bilaterally); (age 61.8 ± 7.6 years). Mean (± SD) FEV 1 before EBV implantation was 0.53 ± 0.15 L (19.8 ± 3.8 % pred.); mean residual volume (RV) was 6.24 ± 1.6 L (287 ± 69.5 % pred.). Left upper lobe was treated 4-times, left lower lobe was treated 7-times, right upper lobe was treated 2-times, right lower lobe 6-times. Patients developed atelectasis in 10/19 (52.6%) cases. Overall, CO 2 was 55.1 ± 9.5 mmHg before and 50.2 ± 12.6 mmHg after 1-3 months (p 2 in patients who developed atelectasis was 57.3 ± 7.74 mmHg before, 53.10 ± 10.6 mmHg at TP2 and 48.7 ± 5.8 mmHg (p 2 levels. The overall pneumothorax rate was 21.1% (4/19 procedures.); all pneumothoraces were treatable by chest tube only. The results of this retrospective analysis show that EBV treatment in patients with hypercapnic respiratory failure is feasible and safe. Successful eLVR may lead to a decrease of CO 2 levels due to improvement in respiratory mechanics. A prospective study has to elucidate the benefit of eLVR in hypercapnic patients.
