[First experience in endoscopic lung volume reduction with the FreeFlow Coil #4: A case series with three patients].

Lung volume reduction therapy is an established treatment for patients with severe emphysema of the lung. In Germany, the treatment with nitinol coils is the only method for endoscopic lung volume reduction in patients with positive collateral ventilation approved by the Gemeinsamer Bundesausschuss. Therefore this procedure can be performed as standard-of-care and has assured reimbursement. After the production of the initial coils was stopped for years, when the only manufacturer had been bought by a large corporation, by the end of 2022 there was a new nitinol-coil, the so called Coil #4, becme available in the European market. The new Coil #4 has a different shape, different application catheter and the implantation procedure differs from that of the original product. We report our experience in endoscopic lung volume reduction with the new Coil #4 in three patients with emphysema. The procedure was performed without complications. All three of them showed improvement in lung function parameters meeting minimal clinically important differences. In two of three patients, we also saw clinically relevant improvement in the 6MWT distance und improvements in SGRQ und CAT-Score. In our opinion, this case series is just a prospect of the possibilities that come with the Coil #4. With due caution, we will continue to offer the Coil #4 as a treatment for selected patients under constant evaluation of the outcome until more data is available.