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Introducing an innovative new emphysema treatment at Royal Brompton & Harefield Hospitals Specialist Care

28 Aug 2019 4:06 PM
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Emphysema patients can suffer from shortness of breath, weight loss, fatigue, persistent wheezing and chesty cough, and more. A type of chronic obstructive pulmonary disease, known as COPD, it is responsible for 30,000 deaths annually in the UK. However, severe emphysema patients can receive a new lease of life, thanks to an innovative new vapour ablation treatment available at Royal Brompton & Harefield Hospitals Specialist Care.

 

How emphysema damages the lungs

Emphysema results in damaged alveoli, tiny air sacs in the lungs. Over time, the inner walls get weaker and they rupture, creating fewer large air spaces rather than the usual many small ones. The surface area of the lungs eventually reduces, and so does the amount of oxygen reaching the bloodstream.

 

Treatments for emphysema

There is no cure for emphysema, but treatment can help to manage symptoms. This may include guidance on smoking cessation, getting a flu jab, patient and carer education, pulmonary rehabilitation, exercise training and breathing retraining, and taking bronchodilators and steroids.

When emphysema gets severe, the elastic tissue of the lungs become so badly damaged that they over-inflate because they can’t empty properly. Air becomes trapped making it much harder to breathe, with less room for fresh, oxygen-rich air to enter, and usually means the person affected will need comprehensive treatment. But recent advances, much of which was pioneered at the Royal Brompton Hospital, means today’s patients have more choices.

 

New vapour ablation treatment leads the way at RB & HH

Dr Samuel Kemp, a consultant in respiratory medicine and an expert in lung disease, regularly assesses patients and determines the most appropriate treatment. This ranges from minimally invasive surgery to devices such as endobronchial valves or coils which reduce lung volume. This allows the healthier parts of the lung to work more efficiently, giving patients relief from their breathlessness.

The very latest treatment is called Bronchoscopic Thermal Vapour Ablation (BTVA). It’s the first ever personalised treatment for emphysema that allows targeted treatment of a patient’s most diseased emphysema segments while leaving the healthier parts alone. According to Dr. Kemp, the treatment is suitable for “anyone who has severe emphysema, who is significantly breathless after pulmonary rehabilitation, and whose lung function tests show their lungs are hyper inflated.”

 

The benefits of steam

If you don’t want surgery or you’re not suitable for valves, steam is an alternative treatment option. If you have diseased lung tissue that’s patchy, steam may be particularly effective because the specialists can be much more selective about which areas of the lung are treated.
For some people, their condition is terrible in one area, but they have relatively well-preserved lung in nearby areas. The advantage of steam is that we can be much more selective about which areas of the lung we treat. Because steam vapour is so easy to direct accurately, it’s much more targeted. According to Dr. Kemp, “with vapour you can do a bit at a time.”

 

How the procedure works

This is a quick treatment carried out under a general anaesthetic. Dr Kemp gently guides the catheter through the airways to the diseased segment of the lung, then delivers a precise, patient-specific dose of steam lasting 3-10 seconds.

An algorithm figures out exactly how much thermal energy is required based on the patient’s lung weight and their overall anatomy to decide the best parts of the lung to treat. This is first established via a CT scan. The treatment is painless, ablating the targeted portion of diseased tissue. It results in a natural, gradual reduction over several weeks, minimising the risk of potentially lethal pneumothorax, a collapsed lung. And patients spend less time in the hospital afterwards.

 

What happens post-treatment?

Patients stay in hospital for 24 hours after the procedure for observation and monitoring. It takes around six weeks for the lung tissue to fully recover and remodel.

Research reveals the treatment maintains lung improvement over time, reducing diseased over inflated lung segments so healthier segments are less crowded and the diaphragm can unflatten as it should. The end result is a person who can breathe more easily, and that means a much better quality of life.

 


 

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