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mikiao
09-02-2010, 03:00 PM
I found this article in a very good English site called breathless with emphysema which was founded by John Kirtley who spent 6 of his last years explaining
all about emphysema to us lay sufferers. I do know of course that stem cells are our best bet, however this implant could help people unlucky with stem cells
to breathe easier and live a few more years. I don?t know where to post this exactly so will post this to the- introductions- where I started the other day.





New Hope For Treatment Of Severe Emphysema: Minimally Invasive Metal Implant Makes Its First Appearance At Berlin Congress

A new type of implant for the treatment of severe emphysema, which can be placed using a simple, non-invasive procedure, has made its first appearance at the Annual Congress of the European Respiratory Society (ERS) in Berlin, to considerable acclaim.

This device - though, to date, tested on only a handful of patients - could provide a viable alternative to the invasive treatments currently used, including lung volume reduction surgery and lung transplants. The new, revolutionary approach was presented to the Congress in three scientific communications that provided an assessment of the new device's feasibility and effectiveness.

Nobody at the Congress could fail to be aware that, in Europe alone, over 13.5 million people have chronic obstructive pulmonary disease (COPD). This is an umbrella term, covering both chronic bronchitis and emphysema, conditions which lead to increasingly disabling breathlessness over time and kill 145,000 Europeans each year. COPD's impact on health costs is close to 700 million euros annually.

One of the underlying pathologies, emphysema, is an irreversible condition caused by a loss of elasticity in the lungs following destruction of the walls of the alveoli, small cavities responsible for gas exchange. When these walls are damaged, air becomes blocked in the lung, which begins to swell, making breathing increasingly difficult.

Over time, the patient becomes more and more short of breath and immunity is compromised, so that the condition becomes increasingly life-threatening.

While there are a number of drugs and other treatments that can alleviate symptoms in milder forms of the disease, severe emphysema is a major challenge. When it reaches an advanced stage, the gold standard consists of surgically removing the diseased parts of the lung, which is extremely invasive and carries a high risk of mortality. Lung transplant is also an option, but remains rare because of a shortage of donors.

There have been several attempts in recent years to develop implants, but success has been limited, largely because the emphysematous lung is characterised by a number of collateral airways that bypass the implant.

No surgery needed

This is the context in which the new device, presented to the ERS Congress by American and German teams, makes its promising debut. The implant, designed to restore or improve the patient's normal breathing mechanism, is made of super-elastic nitinol (a metal alloy). It aims to compress the lung tissue, restore its elasticity and reduce the excessive swelling of the emphysema-affected lung.

Unlike the current invasive surgical procedures, placement of the implant is carried out using only a bronchoscope, a small, flexible tube inserted in the lungs through the mouth, without any need for surgery or incision.

barbara
09-02-2010, 07:09 PM
Do you know when this article was written? I don't see a date anywhere.

mikiao
09-02-2010, 07:40 PM
I found it at www.emphysema-copd.co.uk once the site opens click forum and then new treatments for copd
I think it is a very good site

barbara
09-02-2010, 09:42 PM
I didn't find it. Does it give a date?

JC the Fox
09-02-2010, 10:20 PM
http://www.medicalnewstoday.com/articles/124303.php

The article has a date of October 6, 2008

I haven't delved into this enough to discern the major differences from the Broncus stents (the ones used in the EASE trials)

carmen868
09-03-2010, 02:51 AM
Is this like the endo-bronchial valve? My doctor here says it will work, but we don;t have such things here in the Philippines. Too bad.

mikiao
09-03-2010, 08:39 AM
On the English site it was posted on and the 9th of june 2010
and was taken from an other site on the 6th of October after an initial test on a handful of people . The artical states that
the broncal stents have other airways which deminish the work of the stents. This tecnique works more I think in the way of lung reduction

JC the Fox
09-03-2010, 09:04 AM
I'm not a physician, so I'm only offering a layman's point of view on these devices. The EASE trial used a stent, which is essentially a hollow tube. The stents were put into place using a bronchoscope. From what I've gleaned, the trials were not as successful as originally hoped for.

The article being discussed calls the newer device just that - a device or an implant. My opinion is that it is a valve - which opens (to let trapped air out of the non-elastic portion of the lungs) and closes (which keeps more air from entering), and operates in one direction only (it returns to its original shape, and I'm not sure whether that is an "open" or "closed" position). These devices are also put into place using a bronchoscope.

There is another article by an American physician, who goes into a lot more detail, and says that results with the newer type valves are inconclusive:

http://www.chestnet.org/accp/pccsu/invasive-procedures-emphysema?page=0,3

mikiao
09-03-2010, 10:46 AM
This is the part of your article that I think relates to the first article, that it reduces lung volume done by broncochoscopy , however despite good results in the beginning
more clinical data is needed as stated. Seems to take a long time to get results as it was first tested in Germany in October 2008 I believe.





Airway Implants

Airway implants, such as nitinol coils (PneumRx Inc; Mountain View, CA) of 10 to 20 cm in length, have been designed for use in patients with either homogeneous or heterogeneous emphysema. These implants, which are straight when housed in the delivery catheter, coil up on deployment and tether the lung. This is hoped to improve elastic recoil and has been shown to reduce lung volumes in explanted lungs.28 The coils are inserted via flexible bronchoscopy under fluoroscopic guidance, with each insertion taking <2 min.29 Preliminary safety data from 6 patients have shown no evidence of pneumothorax, postobstructive pneumonia, or coil migration.30 Bilateral lung volume reduction was attempted with coils inserted in a staged manner via two bronchoscopic procedures 3 months apart. Maximal reduction in lung volume occurred between 2 and 4 weeks after implantation and there is some suggestion of improvements in spirometry, exercise capacity, and quality of life.29 Despite these promising results, concerns remain that by distorting bronchi the coils will cause bronchiectasis, and that by kinking pulmonary vessels, the coils will cause pulmonary infarcts. If pleural adhesions are present, implanted coils can also cause visceral pleural tears and pneumothoraces. Therefore, more clinical data are needed to clarify the long-term safety and efficacy of airway implants.

JC the Fox
09-06-2010, 12:41 PM
There are at least two trials utilizing the valves:

Virginia: http://www.centerwatch.com/clinical-trials/listings/studydetails.aspx?StudyID=107148

New Jersey: http://www.centerwatch.com/clinical-trials/listings/studydetails.aspx?StudyID=156577

The clinical trial link that I used - http://www.centerwatch.com/clinical-trials/listings/studylist.aspx?CatID=59 - shows the study in Virginia as being new. However, the company doing the study (Spiration) shows that this is an older trial, and is ongoing, but closed for new participants.

Jan
09-06-2010, 07:37 PM
I have 3 Zephyr Endobronchial Valves in my right lung. I was able to qualify for the clinical trial in 2005. The valves have really helped me. Since then, I do not have to use oxygen 24/7. I use 2L at night with my BiPap and Only use it during the day when exercising or doing strenuous walking. I would get them in my left lung if the FDA would approve them. They are approved in Europe, Asia and China and saving lives there. It is disgusting to me that we in the USA invented these valves and other countries are benefiting from them but not our citizens.

http://abclocal.go.com/wls/video?id=6987065

http://www.pulmonx.com/

The minimally invasive procedure is designed to mimic the results obtained through lung volume reduction surgery. The one-way valves are inserted into the lungs, via the throat, using a flexible instrument called a bronchoscope. The valves conform to fit the airway, allowing normal clearance of air and mucous, but preventing air from flowing into poorly functioning areas of the lung. In theory, this causes diseased areas of the lung to collapse and allows healthier areas to expand, thus increasing oxygen exchange.

Jeannine
09-08-2010, 06:00 PM
Thanks Jan

I checked out the Pulmonx website and found the valves you had inserted in your clinical trial five years ago are available WORLDWIDE except in US and Canada:

http://www.pulmonx.com/index.php?option=com_content&view=article&id=56&Itemid=60

This is an outrage. I wonder what can be done about this? Anyone have any ideas?