Doctors and researchers are testing a new procedure that doesn’t involve surgery to help patients with a devastating lung disease called chronic obstructive pulmonary disease (COPD).
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COPD, which encompasses a group of conditions, is permanent lung damage that gets worse over time. The two most prevalent forms of COPD are chronic bronchitis and emphysema. People with COPD cannot catch their breath and may feel as though they are suffocating.
COPD treatment focuses on lifestyle changes, such as quitting smoking. COPD treatment also may involve medicines, such as steroids or inhaled medications called bronchodilators. These medications may stop working over time.
A procedure called lung volume reduction surgery also is available. The surgery usually is a last resort reserved for people with severe symptoms that have not improved with medication.
In the procedure, surgeons remove damaged tissue from the lungs. In carefully selected patients, lung volume reduction surgery can improve shortness of breath, quality of life and survival.
But there are downsides to lung volume reduction surgery. The surgery has risks, including a prolonged recovery time and discomfort from the surgical scar, says pulmonologist Joseph Cicenia, MD.
Treating damaged tissue
The new procedure, which researchers are testing in clinical trials at Cleveland Clinic and other hospitals across the U.S., helps the damaged lung tissue to regain elasticity lost to disease.
Doctors insert special flexible scopes through the patient’s mouth to place metal coils into the damaged tissue of the patient’s lung. The coils return elasticity to the diseased tissue, allowing the lungs to work in a more normal way.
“We’re actually treating the lung by adding back elasticity to it that it had lost,” says Dr. Cicenia, who is one of the researchers in the clinical trial and has performed the procedure.
“When you lose elasticity it takes a lot longer to empty the lungs, which leads to the lungs hyperinflating,” Dr. Cicenia says.
This hyperinflation is the key factor to why patients with COPD feel short of breath, Dr. Cicenia says.
“If you add back lost elasticity, you reduce hyperinflation and potentially improve shortness of breath,” he says.
Return of lung function
The coils have been in use in Europe since 2008. Patients who received the coils as part of clinical studies there reported substantial improvements in their lung function, capacity for exercise and quality of life.
In general, patients recover from the coil procedure much more quickly than traditional surgery because it is non-invasive.
Traditional surgery requires a large incision, or several small ones, in the chest to remove the diseased tissue. With the lung coil procedure, most patients go home after an overnight stay at the hospital.
“The preliminary results are promising,” Dr. Cicenia says. “Patients are having significant improvements in how far they can walk and their quality of life.”
Preliminary studies have shown the coil procedure gives results that are comparable to the volume reduction surgery, Dr. Cicenia says.
“These early findings need to be confirmed in a larger clinical trial like the one we’re participating in now,” he says.
COPD is a major cause of disability, and is the third leading cause of death in the U.S. Millions of people have a COPD diagnosis. Many more people may have the disease and not know it, according to the National Institutes of Health.
Read the Cleveland.com story: Cleveland Clinic study uses metal coil implants to help emphysema patients with breathing