Researchers at National Jewish Health are testing an investigational treatment to learn if poking holes in the lungs of emphysema patients can immediately help them breathe more easily. Destruction of lung tissue caused by emphysema can leave lungs stiff and overinflated with air that cannot escape. The holes, kept open by small stents inserted during a minimally invasive procedure, could relieve the hyperinflation of the lungs, allowing the healthy parts of the lungs to more easily inflate and take in air.
“Advanced emphysema patients are often in poor physical condition, struggling with each breath,” said Ali Musani, MD, FCCP, principal investigator of the study at National Jewish. “If patients can breathe easier it is likely to improve their quality of life.”
During the airway bypass procedure, new openings are created in the airway wall connecting the damaged lung tissue to the natural airway. These pathways are supported and kept open by Exhale® Drug-Eluting Stents – manufactured by Broncus Technologies, Inc.
“Airway bypass is groundbreaking because right now it is the only treatment being studied to help emphysema patients whose disease has destroyed tissue throughout the lung,” said Dr. Musani. “If successful this minimally invasive procedure would help those who would not otherwise be considered for or benefit from lung volume reduction surgery.”
Emphysema, a component of chronic obstructive pulmonary disease (COPD), is a chronic, progressive and irreversible lung disease characterized by the destruction of lung tissue. The loss of the lungs’ natural elasticity and the collapse of airways in the lung combine to make exhalation ineffective, leaving emphysema sufferers with hyperinflation because they are unable to get air out of their lungs. Breathing becomes inefficient and patients have to work very hard just to breathe.
National Jewish is currently recruiting patients for the EASE trial. The study will last from 15 months to 5 years, depending if the patient is randomized to the control or the treatment group. During the airway bypass procedure physicians will use a Doppler probe inserted through the bronchoscope to identify a site in the airway that is away from blood vessels. A special needle is then used to make a small opening and an Exhale-Drug-Eluting-Stent is placed in the passageway to keep it open. The procedure involves placing up to six drug-eluting stents.
Although this procedure is still under clinical investigation, feasibility data suggest it may hold promise for patients with emphysema. Results from the feasibility study were published in the October 2007 issue of the Journal of Throacic and Cardiovascular Surgery. Positive results included a statistically significant reduction in the amount of air trapped in the lungs and an improvement in breathing for patients at six months after the airway bypass procedure.
“Given that emphysema, which permanently destroys lung function, is such a devastating disease, any potential new treatment option could offer substantial relief to the millions who suffer,” said Dr. Musani.