Document resource
Background Bronchoscopic thermal vapour ablation (BTVA) is a treatment option for selected patients with severe emphysema, inducing lung volume reduction through a localised inflammatory response. This study investigated sex-specific differences in outcomes and safety after BTVA.Methods Data from the multicentre BTVA post-market registry (December 2018–July 2024) were retrospectively analysed. Sex-specific outcomes at 3, 6 and 12 months were compared, and the effect of sex on residual volume (RV%) was assessed using an adjusted mixed-effects model.Results A total of 231 patients (105 women) were included. In women, significant improvements were observed in forced expiratory volume in 1 s at 3, 6 and 12 months (+60 mL, +70 mL, +20 mL), RV at 6 and 12 months (–0.38 L and –0.50 L), 6-Minute Walk Distance (6-MWD) at 3 and 6 months (+17.5 m and +23.5 m), and a consistent improvement in St. George’s Respiratory Questionnaire (SGRQ) at 3, 6 and 12 months (–9.3, –6.9, –9.1). In men, significant improvements were noted in RV at 3, 6 and 12 months (–0.32 L, –0.47 L, –0.32 L) and in SGRQ at 3 and 6 months (–4.8 and –3.7), but not at 12 months. An improvement in 6-MWD was not observed in men. Additionally, a significant time-by-sex interaction was observed for RV% (χ²=5.88, p=0.015), indicating distinct RV trajectories between the sexes.Conclusions The results indicate that women experienced greater improvements in lung function and SGRQ scores after BTVA, which may be explained by differences in perception and reporting of functional benefits, as well as potential biological factors such as a stronger inflammatory response.