Overview
A Study at Two Hospitals Testing the Safety and Effectiveness of the IAB 50 Flex, a New Implant for Adults with Severe COPD or Emphysema
Eligibility
Inclusion Criteria:
- Signed Informed Consent
- Diagnosis of COPD/emphysema
- At least 22-years of age
- 18 ≤ BMI ≤ 32
- 6-minute walk Distance of between 100 - and 400 meters
- Stable disease with less than 10-mg prednisone (or equivalent) daily
- Non-smoking for 4-months prior to screening interview (this includes tobacco, vaping, marijuana, etc.).
- FEV1 between 15% and 45% of predicted value at baseline exam
- FEV1/FVC \<70%
- Subject has ≥25% emphysema destruction score in each lung defined by areas of low attenuation less than -950 HU, as determined by CT core lab.
- Subject has homogeneous or heterogeneous emphysema, and at least one lung has a 15% difference between upper and lower lobes in emphysema destruction score less than -950 HU, as determined by CT core lab.
- RV \> 175% of predicted value.
- mMRC score ≥ 2
Exclusion Criteria:
- Currently participating in another clinical study that involves surgery, interventional or pharmaceutical treatment
- α-1 Antitrypsin deficiency
- Women of child-bearing potential
- More than 2 COPD exacerbation episodes requiring hospitalization in the last year prior to screening
- Any COPD exacerbations requiring hospitalization within 6-weeks of planned intervention
- Two or more instances of pneumonia episodes requiring hospitalization in the last year prior to screening
- Clinically significant mucus production or chronic bronchitis
- Myocardial Infarction or unstable / uncontrolled congestive heart failure within 6-months of screening
- Prior lung transplant, LVRS, bullectomy, lobectomy or endoscopic lung volume reduction (ELVR)
- Clinically significant bronchiectasis
- Unable to safely discontinue anti-coagulants or platelet activity inhibitors for 7-days
- Uncontrolled pulmonary hypertension (systolic pulmonary arterial pressure \>45 mm Hg) or evidence or history of cor pulmonale as determined by recent echocardiogram
- Suspected malignant pulmonary nodule or other lung cancer
- HRCT collected per CT scanning protocol within the last 6 months of screening date and evaluated by clinical site personnel using 3D segmentation software shows:
- Large bullae encompassing greater than 30% of either lung
- Insufficient landmarks to evaluate the CT study using the software as it is intended
- All lobes are less than 25% parenchyma diseased (\< -950 HU).
- Any cardiac comorbidity which the PI believes would compromise the safety of the patient after an IAB implant
- TLC \< 100% predicted at screening
- DLCO \< 15% or \> 50% of predicted value at screening
- PaCO2 \> 50 mm Hg at screening
- PaO2 \< 45 mm Hg in room air at screening
- Plasma cotinine level \> 13.7 ng/ml or carboxyhemoglobin (arterial or ear lobe capillary) \>2.5% at screening.
- Current diagnosis of substance abuse disorder.
- Current diagnosis of any of the following: Major Depressive Disorder (MDD), Schizoaffective Disorder, Schizophrenia, Borderline Personality Disorder, Bipolar Disorder
- Any other conditions, which, in the opinion of the Investigator, would make the patient unsuitable for inclusion, or could interfere with the patient participating in or completing the study.


