VUMC offers minimally invasive, non-surgical alternative for patients with emphysema

Vanderbilt University Medical Center will be the first in the state to offer a minimally invasive, non-surgical alternative for patients with emphysema.

The procedure, called Endobronchial Lung Volume Reduction (ELVR), is for patients with emphysema who have hyperinflated lungs. These patients can inhale but have difficulty exhaling because air trapped in their lungs causes them to become hyperinflated. Until now, such patients were typically treated with inhalers, lung surgery to reduce volume or lung transplants.

The new treatment consists of placing a medical device called a Zephyr valve that blocks airways feeding to the hyperinflated part of the lung, resulting in deflation of that damaged lung. The remaining lung expands and becomes more efficient, and patients breathe easier almost immediately, Rickman said. They can walk farther and have less shortness of breath.

It's an exciting thing. This is the first mechanical treatment that has been approved by the FDA for minimally invasive treatment of emphysema."

Otis Rickman, DO, associate professor of Medicine and Thoracic Surgery and founder of Vanderbilt's Interventional Pulmonology Program

The Zephyr Endobronchial Valve is an endoscopic lung volume reduction therapy that has been proven to significantly improve lung function, exercise capacity and quality of life for emphysema patients across four randomized, controlled clinical trials and in 12,000 patients worldwide.

To place the devices, a bronchoscope is advanced into the patient's lungs while under general anesthesia. The bronchoscope, with a light and camera, travels down the windpipe into the patient's lung to allow doctors to place the device; no incision is necessary.

Following the procedure, which lasts about an hour, patients will be monitored in the hospital for three to four days.

Vanderbilt is the only center in Tennessee to offer the procedure. The Medical Center has participated in two clinical trials of ELVR devices over the last several years with excellent results, Rickman said.

The procedure is intended for patients with the type of emphysema with hyperinflated lungs. Patients considered for the procedure will first receive a CT scan that will be analyzed with advanced computer software in order to determine if the distribution of emphysema is the type that the devices can help. If so, then more extensive testing takes place, followed by six weeks of optimal medical therapy, including inhalers and rehabilitation. Then, the procedure is performed.

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