Investigational Nonsurgical Device for Emphysema

SALT LAKE CITY, Utah—An investigational noninvasive alternative to lung reduction surgery may become a new option for patients with emphysema who are not candidates for surgery, presenters said at the American College of Chest Physicians annual meeting.

In a multicenter preliminary pilot study, the safety and efficacy of the IBV Valve (Spiration) was tested on patients with severe upper-lobe emphysema. During a 27-month period, flexible bronchoscopy was used to implant 520 IBV valves in the upper lobes of the lung in 75 patients. An average of 6 to 7 valves was implanted in each patient.

In 46 of the patients receiving this umbrella-like valve, the treatment transferred an average of 20% of ventilation and perfusion to the healthier regions of the lung. At 6 months, two thirds of the responders showed significant improvements in oxygen use and the diffusion capacity of carbon monoxide.

Compared with nonresponders, the 46 patients who responded to treatment were younger (<75 years), did not have lingular treatment, and had fewer lung segments treated.

There were no reports of device migration or erosion.

&#8220;Patients responding to valve treatment may now be able to do simple, everyday activities&#8230;talk without trouble breathing, and can go out for shopping and entertainment,&#8221; said coinvestigator Atul C. Mehta, MD, FCCP, of the Cleveland Clinic Foundation. &#8220;Although valve treatment is still investigational, it may offer an alternative treatment for patients with emphysema who are not good candidates for lung-volume reduction surgery.&#8221;