Effects of a Novel Implantable Elastomer Device for Lung Volume Reduction Surgery in a Rabbit Model of Elastase-Induced Emphysema

Brenner, Matthew; González, Xavier; Jones, Beth; Ha, Rick W.; Osann, Kathryn; McKenna, Robert J.; Milliken, Jeffrey C.

doi:10.1378/chest.121.1.201

Cited by 22 publications

(5 citation statements)

References 34 publications

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“…Technological developments that simplify surgical procedures are one example [119,121] and bronchoscopic procedures another [122]. The former include no-cut plication procedures [119,121] and the latter procedures in which bronchoscopic collapse is obtained which is consolidated with tissue glue [123] or the implantation of valves [122].…”

Section: Future Developmentsmentioning

confidence: 99%

Treatment of chronic respiratory failure: lung volume reduction surgeryversusrehabilitation

Decramer¹

2003

Eur Respir J

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Several treatment options are available for end-stage chronic obstructive pulmonary disease (COPD). Respiratory rehabilitation and lung volume reduction surgery are reviewed here. Respiratory rehabilitation can now be considered a prime treatment for COPD. Indeed, it has been clearly shown to improve exercise capacity and health status in these patients. Improvements in the former fell just below the minimal clinically important difference, whereas those in the latter exceeded it. In addition, after a respiratory rehabilitation programme, a reduction in the number of hospital admissions and duration of each admission was demonstrated.It remains, however, difficult to predict accurately which patients will improve after rehabilitation and which will not. Factors that may contribute to this prediction are: baseline peak exercise ventilation/maximal voluntary ventilation, maximal inspiratory pressure, peripheral muscle force, and 6‐min walking distance. Several studies have clearly shown that training effects are as pronounced in patients with severe as in those with moderate airflow obstruction. This is the most significant insight in this area of the 1990s.Lung volume reduction surgery may also be of benefit in patients with end-stage COPD. It is clear that lung function, exercise capacity and health status improve after this procedure, although the results of only six randomised studies are currently available.It remains difficult to accurately predict which patients will benefit from the procedure. From a model analysis, the most important action mechanism appears to be resizing of the lungs. Only in patients with an increased residual volume/total lung capacity ratio are beneficial effects expected. The model analysis, however, did not fit the experimental data very well in a recent publication. Emphysema heterogeneity is also likely to be related to the response. The question remains as to whether or not lung volume reduction surgery accelerates the decline in forced expiratory volume in one second in the long run. The technique is undergoing considerable progress as numerous new surgical and endoscopic procedures are currently being developed. The results of these procedures have not yet been systematically evaluated.

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Section: Future Developmentsmentioning

confidence: 99%

Treatment of chronic respiratory failure: lung volume reduction surgeryversusrehabilitation

Decramer¹

2003

Eur Respir J

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“…In published investigations of this approach, effective LVR was reported in small 52 and large animal emphysema model models, [55][56][57] and was indicated by compliance curve responses, with minimal morbidity, and significant reduction in the incidence of air leak 52,[55][56][57] (Figs 1-3).…”

Section: Surgical Resection With Compression-banding Devicesmentioning

confidence: 99%

“…Such a methodology could be relatively straightforward to apply, and rapid, incremental administration might be possible. 52,[55][56][57] Loading, insertion, deployment, and device fixation methods must be optimized for this approach.…”

Section: Surgical Resection With Compression-banding Devicesmentioning

confidence: 99%

“…In addition, tissue strain forces must be addressed, particularly at the sites of proximal contact between the volume reducer material edges and the lung. These issues were the focus of the preclinical animal studies, 52,[55][56][57] and further evaluation is continuing in the clinical trial phase.…”

Section: Surgical Resection With Compression-banding Devicesmentioning

confidence: 99%

“…Reprinted with permission from CHEST. 52 fusion mismatch and hypoxemia if lung regions with persistent pulmonary blood flow are obstructed (without concurrent elimination of the corresponding circulation). Questions arise about the risk of postobstructive infection.…”

Section: Endobronchial Airway Sealantsmentioning

confidence: 99%

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Innovative Approaches to Lung Volume Reduction for Emphysema

Brenner

Hanna

Mina-Araghi

et al. 2004

Chest

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The 10 years of resurgent interest in lung volume reduction surgery (LVRS) and recent National Emphysema Treatment Trial findings for emphysema have stimulated a range of innovative alternative ideas aimed at improving outcomes and reducing complications associated with current LVRS techniques. Concepts being actively investigated at this time include surgical resection with compression/banding devices, endobronchial blockers, sealants, obstructing devices and valves, and bronchial bypass methods. These novel approaches are reaching the stage of clinical trials at this time. Theory, design issues, methods, potential advantages and limitations, and available results are presented. Extensive research in the near future will help to determine the potential clinical applicability of these new approaches to the treatment of emphysema symptoms.

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Lung Volume Reduction

and¹,

Geddes²

2005

Evidence‐based Respiratory Medicine

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Effects of a Novel Implantable Elastomer Device for Lung Volume Reduction Surgery in a Rabbit Model of Elastase-Induced Emphysema

Cited by 22 publications

References 34 publications

Treatment of chronic respiratory failure: lung volume reduction surgeryversusrehabilitation

Treatment of chronic respiratory failure: lung volume reduction surgeryversusrehabilitation

Innovative Approaches to Lung Volume Reduction for Emphysema

Lung Volume Reduction

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