New Devices May Bring a Breath of Fresh Air to Those With Emphysema

Life with the emphysema is a life spent gasping for air, straining like a marathoner to suck in oxygen after every stroll to the fridge or the mailbox. Yet for all its severity and prevalence, the disease has few available treatments, and they are surprisingly low-tech. Except for severe cases, surgery to remove diseased portions of the lungs is too risky. Instead, the newly-diagnosed emphysema patient is sent home with pills, inhalers, and a cumbersome oxygen tank.

But all that may soon change. David Ost, M.D., Director of Interventional Pulmonology, is part of a team that is testing two new devices, implanted directly into lung tissue, designed to relieve suffering by diverting air from sick lung areas to healthy tissues that need it. The fingernail-size devices - Intra-Bronchial Valve (IBV) and Exhale Airway Stents for Emphysema (EASE) - are for a particular type of emphysema.

One result of the progressive hardening and crumpling of the lungs' microscopic air sacs is the buildup of stale air in the non-working parts of the lung. Emphysematic tissue can't process the air it receives, but it can't get rid of the extra gas either. This leads to hyperinflation of the lungs, which often becomes so extreme that it's visible - people with emphysema sometimes develop a barrel chest.

While the umbrella-shaped IBV valve is best for patients whose disease is limited to the upper lobes, the artery-style EASE stent is suited to those whose damage is more dispersed. While both devices offer trapped air a path for escape, only the valve actually blocks off sections of lung. Neither procedure requires invasive surgery -they're done using a bronchoscope that travels deep into the lungs. Valve installation doesn't involve cutting at all, while the stent insertion requires poking a needle through small sections of lung to create airways.

So how does that first breath feel after you wake up from the procedure? "It's tough to say," says Dr. Ost. He's witnessed scenes of foggy-eyed patients, breathing better in the recovery room than they have in many years. "But we don't really know yet how patients will feel," he adds. "That's why we're doing the study."

For information on how to participate in this clinical trial, call (212) 263-4170.

Originally published in News & Views, July/August 2008