Royal Preston Hospital steams ahead with innovative emphysema treatment

A specialist at Royal Preston Hospital has performed his first procedures utilising steam therapy on two severe emphysema patients as part of a research registry study.

Dr Mohammed Munavvar, Consultant Chest Physician and Interventional Pulmonologist at Lancashire Teaching Hospitals, is using the innovative Bronchoscopic Thermal Vapour Ablation (BTVA) treatment, which originated in the US and has only been used at one other hospital in the UK.

Emphysema is a type of chronic obstructive pulmonary disease (COPD), which involves damage to the air sacs in the lungs. People with emphysema often develop unpleasant symptoms that can make their daily life difficult, such as shortness of breath, persistent cough and fatigue.

BTVA treatment involves the application of heated water vapour (steam) to the area of the lung affected by emphysema, which lasts between three and ten seconds. Over the next few days and weeks, the diseased and hyper-inflated areas shrink. This allows the healthier lung tissue to expand, which, in turn, alleviates symptoms.

One patient, who received BTVA and wishes to remain anonymous, said: “You wouldn’t think I was ill to look at me, but before I had the new procedure, I couldn’t exercise. I struggled to finish the 6-minute walk test in the hospital - even taking a shower and housework was difficult. I had to think carefully about where I was visiting when I went out. BTVA has given me my mojo back. I’m much more active and I am actively seeking things to do rather than just sitting on the sofa.”

Almost one in 20 people older than 40 years of age live with chronic obstructive pulmonary disease (COPD), and many COPD patients develop emphysema, a condition where the ‘walls’ between the tiny air sacs (alveoli) at the end of the lung’s airways break down.

Dr Munavvar stresses that BTVA is just one part of a package individualised to each patient’s symptoms, disease and plans.

He said: “As a standard, we offer advice on smoking cessation, pulmonary rehabilitation, exercise and breathing retraining, bronchodilators, which open the airways, and if appropriate, steroids that dampen inflammation, before considering further intervention. Of course, everyone with COPD should ensure they receive their annual flu jab.”

Dr Munavvar continued: “Because the changes to the lung are gradual and the treatment involves water vapour, most patients do not experience significant side effects. There is a small risk of a COPD exacerbation and pneumonia, and it is important to note that BTVA isn’t the right treatment for everyone with emphysema. So, we discuss the possible risks and likely benefits with each carefully selected patient, and carry out the procedure after obtaining written informed consent, within the context of an emphysema research registry.”

The Emphysema/COPD Research Registry collects data about a large number of patients with severe emphysema, to offer accurate insights into how well BTVA and other treatments work, which patients are most suitable for the new procedure and if there are any side effects.

For further information contact Lana Fashioni  [email protected] 

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