A new umbrella-like valve may help patients with emphysema breathe easier and may ultimately provide a noninvasive alternative to lung reduction surgery. In a new study presented at CHEST 2006, the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP), the IBVTM Valve, a nonsurgical, investigational device, was shown to be safe and effective for patients with emphysema.
Emphysema -- a subtype of chronic obstructive pulmonary disease (COPD) -- is a progressive and debilitating lung disorder, characterized by irreversible airflow obstruction. Current management for emphysema includes medication and/or supplemental oxygen, pulmonary rehabilitation, and, in rare cases, lung volume reduction surgery (LVRS) to remove the most diseased portions of the lung.
"The IBVTM Valve is similar in concept to LVRS in that it aims to make the lungs work more efficiently, thereby decreasing shortness of breath," said the study's lead author Daniel H. Sterman, MD, FCCP, University of Pennsylvania Medical Center, Philadelphia, PA. "Unlike lung reduction surgery, valve treatment has fewer complications and a shorter hospital stay. For example, most valve-treated patients have a one-night observational hospital stay while surgical patients average a week or more in the hospital." The one-way IBVTM Valve limits ventilation in diseased areas of the lungs and redirects ventilation to the remaining healthier portions of the lung while allowing for normal clearance of secretions.
In a multicenter preliminary pilot study, Dr. Sterman and researchers from the Cleveland Clinic Foundation, Cleveland, OH, University of Washington, Seattle, WA, and six additional US medical centers examined the safety and effectiveness of the IBVTM Valve on patients with severe upper-lobe emphysema. Over a 27-month period, 520 valves were implanted in 75 patients across the nine medical centers. The valves were implanted in the upper lobes of the lung using flexible bronchoscopy, with an average of 6 to 7 valves implanted per patient. Researchers used quantitative software and multidetector CT scans to measure the physical effects of the valves and the St. George Respiratory Questionnaire (SGRQ) to assess how patients felt after treatment.
Of the patients who received valve treatment, 46 patients (group A) had reduced complications and retained efficacy compared with the remaining patients (group B). In responding patients, valve treatment transferred an average of 20 percent ventilation and perfusion to healthier regions of the lung. Two thirds of patients in group A also had a 4-point or more SGRQ improvement at 6 months and showed significant improvements in oxygen use and DLCO. Compared with patients in group B, patients in group A were less than 75 years old, did not have lingular treatment, and had fewer lung segments treated. The 90-day serious complications were one bronchospasm and one COPD flare in the A group and two bronchospasm and one death with pneumothorax in group B.
"Patients responding to valve treatment may now be able to do simple, everyday activities, such as bathe or shower independently, walk around the house without stopping, talk without trouble breathing, and can go out for shopping or entertainment," said study coauthor Atul C. Mehta, MD, FCCP, Cleveland Clinic Foundation. "Although valve treatment is still investigational, it may offer an alternative treatment for patients with emphysema who are not good candidates for LVRS." Researchers stress that valve treatment is not yet approved by the US Food and Drug Administration and is only available as part of a research trial that is currently sponsored by the developer of the IBVTM Valve, Spiration, Inc.
"Although there is no cure for emphysema, proper treatment can improve a patient's exercise capacity, overall quality of life, and may result in longer survival," said Mark J. Rosen, MD, FCCP, President of the American College of Chest Physicians. "Valve treatment may represent a valuable option for the palliative treatment of patients with emphysema."
Jennifer Stawarz | EurekAlert!
A promising target for kidney fibrosis
21.04.2017 | Brigham and Women's Hospital
Stem cell transplants: activating signal paths may protect from graft-versus-host disease
20.04.2017 | Technische Universität München
More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.
Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...
Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.
"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...
The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.
Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...
The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...
Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.
Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...
20.04.2017 | Event News
18.04.2017 | Event News
03.04.2017 | Event News
25.04.2017 | Physics and Astronomy
25.04.2017 | Materials Sciences
25.04.2017 | Life Sciences