Aeri-Seal

[johnwr]

I pinched this article off Facebook.

As a treatment for Emphysema, I think it has a place amongst the others. I wonder if it has relevance for those with Collateral Ventilation, where other treatments are not a good option because of air leakage between the lobes in the lung through damaged tissue. It's early days yet for this system, so there is much to learn. I suspect this first piece was written by a journalist.

(1)

First Patient in United States Gets New Emphysema Treatment

Mar 22, 2013 by Scott

New Emphysema Treatment

A new treatment for emphysema is undergoing testing in the United States, after already getting approved in Europe and Israel. It is a foam that is sprayed into the lungs and is used to decrease inflammation in the lungs in people with severe emphysema. A man by the name of Perry Waldrop of Alabama jumped at the chance of being the first person in the US to undergo this new procedure.

Emphysema is a chronic lung condition that falls under the term of Chronic Obstructive Pulmonary Disease and its characterized by the damaged alveoli, which are the tiny sacs in the lungs that transfer oxygen and carbon dioxide from the lungs to the bloodstream and vice versa. The alveoli in a person with emphysema are so damaged, that they are unable to exhale the carbon dioxide and inhale oxygen, resulting in lungs that have become too expanded. This condition is caused by smoking and about 4.9 million Americans are known to have this disease.

These larger than normal lungs will then put excessive pressure on the diaphragm, preventing it from rising and falling as it should, and making it even more difficult to breathe. This enlargement of the lungs due to emphysema can also cause the lungs to collapse if the enlargement is located around the tops of the lungs.

Someone with severe emphysema, like Mr. Waldrop, will very low amounts of energy because of the lack of oxygen in their blood stream. This condition is extremely dangerous for other parts of the body as well, especially the brain, which needs about 20% of the oxygen we breathe, and the heart, which will try to overcompensate for the lack of oxygen in the bloodstream and work itself to the point of heart failure. People who have severe COPD often use large amounts of oxygen therapy to make up for the way their lungs cannot inhale enough oxygen.

The substance used for this procedure is called “Aeri Seal” and it’s actually a polymer that is apply to the lungs. To components to the polymer mix together on contact and harden to form a rubbery foam. This foam seals off the air sacs in the damaged area of the lung, which causes the lung to shrink back down to normal over time, and the foam shrinks and breaks down over time as well. When the lung has decrease back to its normal size, the diaphragm can work as its supposed to.

It’s still too soon to see exactly how safe and and effective this procedure is, it is predicted to be safer than surgery to remove damaged areas of the lungs. Lung surgery on patients with emphysema has been known to be high risk and have complications down the line.

The patient undergoing the procedure is put under light anesthesia and it only takes about 45 minutes to perform. During the months after the procedure, the patient still uses oxygen therapy until a doctor can determine whether or not he still needs it.

The procedure took place in October of 2012 and as of February of 2013, Waldrop is on his way to recovery, already seeing a difference in how well he can breathe.

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This second article, I pinched from the Journal of Bronchology & Interventional Pulmonology

Link to this article is:

journals.lww.com/broncholog...

(2)

Treatment of Severe Advanced Emphysema With Volume Reduction Using Lung Sealant: A Case Report of 2 Patients

Authors: Falkenstern-Ge; Roger F.; Ingerl, Hermann; Kohlhaeufl, Martin

Abstract: image Background: Emphysema is a progressive and irreversible disease for which there is no cure to date. The patients experience debilitating shortness of breath with repetitive exacerbations and poor quality of daily life. At present, patients with severe emphysema have limited treatment options. Endoscopic lung-volume reduction with valve implantation or using lung sealant is a treatment option for patients with severe emphysema. By our patients, we detected collateral channels, which allow airflow into the target lobe and prevent atelectasis and significant lung-volume reduction. Thus, we decided to treat the advanced emphysema of our patients with endoscopic volume reduction using lung sealant (AeriSeal). Lung-volume reduction surgery reduces hyperinflation and improves lung function by removal of emphysematous lung tissue. However, lung-volume reduction surgery is also associated with significant short-term morbidity and mortality. Results from recently published Endobronchial Valve for Emphysema Palliation Trail (VENT) and Exhale Airway Stents for Emphysema (EASE) trial showed that treatment was substantially less effective and did not consistently reduce hyperinflation or improve lung function mostly likely due to collateral ventilation present in majority of patients. There is a volume reduction therapy in case of detection of collateral flow; use of a lung sealant is a possible alternative. Methods: A novel endoscopic tissue sealant (AeriSeal; Aeris Therapeutics, Woburn, MA) is a liquid foam sealant that collapses hyperinflated lung areas destroyed by emphysema. The foam of lung sealant AeriSeal is instilled into the peripheral airways and alveoli where it polymerizes and functions as tissue glue, forming a film of material on the lung surface that seals the target region to cause durable absorption atelectasis. Results: Two patients with advanced emphysema and hyperinflation underwent endoscopic volume reduction with endoscopic tissue sealant (AeriSeal); collateral flow was confirmed by using the Chartis System. Both patients experienced transient fever, malaise, chest discomfort, and shortness of breath for about 3 days after the procedure. Over a period of 8 and 12 weeks, the air within the sealed region was absorbed and the treated area showed atelectasis on computed tomography scan. The follow-up evaluations of those 2 patients showed improved lung function (increased FEV1, and a reduction of TLC and RV) with improved quality of life of both patients. Conclusions: Correlation and comparisons between changes in primary and secondary outcome measures in the lung function parameters and 6-minute walking test before and after the application of AeriSealant revealed significant reduction of hyperinflation and improvement both in the flow rates and physical capacity of our patients.

Keywords: Case Reports

PubDate: Tue, 01 Jan 2013 00:00:00 GMT-

DOI: 10.1097/LBR.0b013e3182824782

Note: There was a picture showing x-ray images with the second article which I was not able to copy here.

Draw your own conclusions.

Breathe easy all.

johnwr

[Scars1]

Intersting, especially as my emphysema is mostly at the top .

[arran]

very interesting

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[libbygood]

Thanks for sharing that, the AeriSeal dosn't sound too expensive.

Lib

[annanother]

this looks like the same blf.healthunlocked.com/blog...

[johnwr in reply to annanother]

I think you are right, annanother. Info is starting to come forward.

[johnwr]

I've also found this press release that may be of interest to some people here.

Pulmonx to Market Zephyr® EBV Therapy for Patients with “Genetic” Emphysema

Company Receives Approval to Revise CE Labeling August 29 , 2012,

Peseux, Switzerland

–

Pulmonx, an emerging leader in interventional pulmonology, announced today that its European notified body has granted CE approval for revised labeling of its Zephyr® Endobronchial Valve (EBV). The approval was based upon an independent review of two separate clinical data sets in which patients with hyperinflation associated with a genetic form of emphysema, Alpha-1 antitrypsin deficiency (AATD), were treated using the Pulmonx Zephyr EBV.

These new data sets reported improvements for FEV1 (forced expiratory volume in one second) and Residual Volume in AATD patients treated with Zephyr endobronchial valves, showing that patients with hyperinflation associated with emphysema can benefit from EBV treatment, independent of the underlying cause of the disease.

No new procedural or device risks that may be associated with the treatment of AATD patients with the Pulmonx EBV were observed. The newly approved labeling provides a therapeutic option for physicians to use the Zephyr EBV to treat patients afflicted withhyperinflation associated with Alpha-1 Antitrypsin Deficiency.

“We have seen great success in the use of endobronchial valve therapy in selected patients suffering from Alpha-1 Antitrypsin Deficiency.” said Gunnar Hillerdal, Associate Professor of Lung Medicine, Karolinska University Hospital, Stockholm, Sweden. “

The treatment options for these patients were previously very limited but their anatomy and the typical distribution of their disease can make them excellent candidates for EBV treatment. The recent label change should encourage pulmonologists to evaluate these patients for such treatment with confidence,”

he continued.

About Alpha-1 antitrypsin deficiency (AATD) is an inherited condition in which the body does not make enough of a protein that protects the lungs and liver from damage. Severe AATD can lead to emphysema or chronic obstructive pulmonary disease (COPD) in adult life.

[KingoftheCocktails]

Always keep up to date properly with the BLF

[copdliving]

I am meeting with a doctor on April 12th to be tested for this therapy. They have asked for my CT scans and PFT results. My lungs are extremely hyperinflated and most of my damage is in the top lobes so I am hoping I can qualify. I am going to the Lahey Cinic in BUrlington MA USA. THe doctor I spoke with said that the 300 patients who have received this treatment in Europe have mostly seen 30% improvement in the FEV1. Visit clinicaltrials.gov and see if there is a trial near you.

[richardcrossroads]

good morning thank you a very interesting piece, i tuened down lung volume reduction surgery 3 years ago, as i was not convinced that it was right for me and i am now the same as i was then if not able to do more, by exercising and healthy living, this is some thing to look at if i get worse,

so thank you again have a good Easter

[katieoxo60]

Thanks for the info, sounds like there could be changes to treatment in the not to distant future, which is good news possibly for younger patients.But for some keeping current health levels will still be the mainstay for life. Have a Happy Easter