This trial is evaluating whether Endobronchial valves placement will improve 4 primary outcomes and 3 secondary outcomes in patients with Emphysema. Measurement will happen over the course of Through study completion, an average of 2 years.
This trial requires 20 total participants across 2 different treatment groups
This trial involves 2 different treatments. Endobronchial Valves Placement is the primary treatment being studied. Participants will be divided into 2 treatment groups. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Inhalation options have emerged as effective treatments with minimal side effects for the management of emphysema. Appropriate use of inhaled bronchodilators such as β-agonists such as salbutamol or corticosteroids such as budesonide are highly effective and may be used concurrently. Inhaled monotherapy with long-acting salbutamol or a corticosteroid, such as budesonide, is efficacious and well tolerated in the long term.
While emphysema is not curable it can be treated. The cornerstone of treatment is smoking cessation. In fact, the benefits of smoking cessation are so strong that, as in the case of diabetes, most patients will be advised to stop before they start getting the disease. The other mainstay of prevention is quitting. This advice would be easier if emphysema could be cured, and then smoking cessation would be easy, but this looks unlikely.
Emphysema is a disease where small pockets form in the lungs. These pockets are filled with pus and have a strong stinky smell. The puffy look of the person's chest may give the disease a caddish sense. The disease is not a life-threatening illness. It is however debilitating as it can cause severe breathlessness and difficulty breathing and coughing. A related condition is a collapsed lung. These conditions will cause a person constant and bad breath. They are also quite unpleasant. Lung disease is often diagnosed at an early stage and there is an urgent need for diagnostic tests.
Rates of emphysema vary widely by age and according to what is being measured. Since the prevalence of emphysema in North America is estimated to be 1-2% for men and 1% for women, we should expect at least about 10-20 million people to have emphysema a year, given the known prevalence of emphysema in North America and the average longevity that prevails in the United States (80 years).
Emphysema is known to be caused by some genetic mutations and toxins. A variety of factors, such as cigarette smoking and air pollution, is found in the asthma population, but the exact cause is unknown. The mechanism is unknown, but it is believed that the cause has a genetic component. Smoking or excessive alcohol use appears to play a role through a process called oxidative stress.\n
Several pathophysiological pathways are involved in the development of emphysema: gas trapping, chronic inflammation, and epithelial cell injury. However, it is still unknown which of these pathways underlie emphysema in patients with alpha-1-antitrypsin deficiency.
If you can see one valve on CT, you can see two valves on HRCT. It is not a single organ. There is not enough data to determine which is the “right” valve depending if one or two are seen on a CT or HRCT. There are two types of valves on the left bronchial tree that we can see on CT/HRCT: the subsegmental valve and the segmental valve. The former is a bundle of lung tissue from which the right mainstem bronchus arises. The segment of this bundle is usually dilated and thickened.
It is difficult to determine the optimal treatment for endobronchial valve disruption in the thoracic surgery literature, as the majority of studies are retrospective. In our experience, this procedure with fluoroscopic visualization of the endobronchial valve is safe, although a certain degree of morbidity can be anticipated. There seems to be a slight trend toward prolonged ventilatory support in our series. In this retrospective study, the risk of mortality and reintervention is very low.
The study shows that the use of endobronchial valves for the treatment of severe emphysema (Sx) appears to be successful when paired with an optimal treatment with respect to age of patient, gender, and disease stage. This may be the most ideal patient group to use endobronchial valves in combination with an optimal treatment in most cases.
Over the last 20 years, many advances in therapies have been made for emphysema. There will be times when the medical community will be able to add many more treatments to the available treatment options. As physicians become more knowledgeable of recent advances in understanding emphysema pathophysiology and treatment, their knowledge will keep growing and most patients will eventually be candidates for the most recent therapies\n
There are no new findings to report on today. The literature search shows that the current literature shows only that we still need to know more about all the factors involved; and we must find ways to communicate our findings to those who can use them to inform healthy people, particularly women, about how to live so as to limit the risk of premature death. Emphysema is not likely to be a 'top priority' in the next few decades as was claimed on television recently. Current estimates for all smokers suggest that it will be a very distant future. But, maybe it could become the number one problem to hit if we don't act very quickly as we should.