A full, deep breath is but a memory. The last walk with the dogs or solo trip to the grocery store? Those might prove difficult to recall, too.
But soon, relief for a long-time emphysema sufferer could come from a handful of tiny, metal coils and a one-hour, minimally invasive procedure.
Frank Sciurba, M.D., has been performing an array of interventions and even working to perfect others in his UPMC Pulmonary Physiology Lab and through the University of Pittsburgh’s Division of Pulmonary, Allergy and Critical Care Medicine Emphysema COPD Research Center. Last Thursday, he and fellow pulmonologist Maria Crespo, M.D., F.C.C.P., used a general anesthetic, a bronchoscope tube and 10 elastic, shape-memory coils to curl up emphysema-diseased areas of the right lung of a 65-year-old Hampton woman who last smoked nearly 30 years ago. By the next morning, she reported her best breathing in years.
“What these coils do is, they go out as long wires, then they fold in the emphysema – the affected portions of the lung,” said Sciurba, referring to the coils made of Nitinol, a metal found in common medical implants, and the focus of this 30-center study funded by PneumRx. “They go in as a 10-centimeter wire, they fold in half, and then they fold in half again – sort of like a baseball seam. And as they fold they roll in the lung.”
That allows the remaining healthier parts of the lung to inhale and exhale easier.
Pulmonologists for years have tried to combat the debilitating disease, often underdiagnosed or misdiagnosed but afflicting an estimated 3 million Americans, with a variety of inhaled steroids, bronchodilators and surgical techniques. Lung Volume Reduction Surgery and lung transplants were more recent attempts, but carried side effects including the potential for infection, Sciurba added, so pulmonologists kept on looking for other ways. Implanted valves also were tried, with mixed results.
Starting in 2008, coils were implanted in candidates across Europe. The U.S. and an expanded European trial is beginning in Pittsburgh, Charleston, S.C., and other cities. Sciurba hopes to enroll 30 local patients in the study encompassing 300-plus across 30 centers.
“If you want to sense what it means to be hyper-inflated (like an emphysema sufferer), take a deep breath to the top of your lungs,” Sciurba said. “Instead of exhaling to your normal relaxed state, you now just exhale a teacup. Breathe this teacup back in and out for a minute. That uncomfortable sensation of hyperinflation is what (emphysema) patients feel every day. That’s what we’re trying to deal with in this intervention.”
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