Treatment Options
While there is no cure for emphysema, a modern, non-surgical treatment called endobronchial lung volume reduction (ELVR) is available in many countries outside the U.S. This treatment has been evaluated in clinical trials and has been shown to alleviate emphysema symptoms and improve breathing for many patients with emphysema.
Many physicians will require their patients to have stopped smoking before being considered for endobronchial treatment. ELVR works by reducing the hyperinflation of the diseased lung, improving breathing mechanics, which often helps patients experience less breathlessness and thus encourages more physical activity, independence, better overall health, and a concurrent positive outlook.1,2,3
Currently, it is not possible to reverse the underlying lung damage that exists in emphysema. Treatment consists of managing the symptoms of the disease with medications, providing some relief for patients. For a few patients, in certain circumstances, other options such as lung transplantation and surgical lung volume reduction may be options.
Endobronchial lung volume reduction is a non-surgical approach that reduces hyperinflation in the diseased lung, allowing healthier portions of the lung to expand and helping the patient feel better. Pulmonx offers both a diagnostic and therapeutic solution for patients. Our diagnostic device, the Chartis® pulmonary assessment system, helps physicians plan treatment by evaluating the target areas of the lung, and our therapeutic device, the Zephyr® endobronchial valve, is used to perform the ELVR procedure. The Zephyr valve has been commercially available in Europe and other markets for a number of years and has successfully been used to treat over 2,500 patients worldwide.
To qualify for endobronchial lung volume reduction, patients with emphysema will undergo a simple assessment of the emphysematous parts of their lungs. This assessment, called a Chartis assessment, will tell physicians whether you are likely to experience significant lung volume reduction from the ELVR treatment. This assessment is important because it gives your physician the information needed to plan your treatment. Like the Zephyr treatment itself, this assessment is performed by using a small telescope (bronchoscope) with is passed through either your mouth or nose into your lungs. The Chartis assessment involves putting a catheter into your lungs through the bronchoscope and inflating a small balloon to assess how much pressure and flow is coming out of the sickest areas of your lung. The test takes 5 – 10 minutes and you can go back home the same day.
The ELVR therapy involves placing approximately 3 one-way valves into the natural airways leading into a target lobe of your lung, also via the bronchoscope. The one-way valves prevent you from drawing more air into the lobe, but allow air and secretions to pass out of the lobe, reducing volume. The procedure takes 10 – 30 minutes, and can be successfully performed either by giving you medication to make you feel sleepy and relaxed during the procedure or by giving you a general anaesthetic so that you are asleep during the entire procedure. Many patients report feeling some relief from breathlessness the same day as their procedure. Patients typically stay in the hospital for just a few days for monitoring.
- Sciurba F, et al. A Randomized Study of Endobronchial Valves for Advanced Emphysema. New England Journal of Medicine, 2010; 363:1233-1244.
- Gompelmann D, Eberhardt R, Ernst A, et al. Predicting Atelectasis Using Collateral Ventilation Assessment prior to Endobronchial Lung Volume Reduction – A Feasibility Study. Respiration 2010;80:419-425; doi: 10.1159/000319441.
- Use of Chartis® Pulmonary Assessment System to Optimize Subject Selection for Endobronchial Lung Volume Reduction (ELVR). Chartis Multi-Centre Study, data presented at ATS2011. Data on file with Pulmonx.
