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Le professeur Ralf Eberhardt présente « l'algorithme d'Heidelberg » pour distinguer les patients devant faire l'objet d'une réduction de volume pulmonaire par bronchoscopie, lors de la réunion 2017 de la Société européenne des maladies respiratoires
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News provided by

Uptake Medical

Sep 25, 2017, 03:26 ET

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MILAN, 25 septembre 2017 /PRNewswire/ -- Lors de la réunion annuelle de la Société européenne des maladies respiratoires, qui s'est tenue la semaine dernière à Milan (Italie), le professeur Ralf Eberhardt, de la Clinique thoracique (Thoraxklinik) d'Heidelberg, a présenté l'algorithme (schéma 1) utilisé dans les pratiques cliniques en vue de choisir la bonne technique pour réduire le volume pulmonaire, sur la base des données actuellement publiées. La réduction de volume pulmonaire est une intervention destinée à soigner les patients souffrant d'emphysème au stade avancé pour améliorer leur fonction pulmonaire, leur tolérance à l'effort et leur qualité de vie. Une fois identifié un patient souffrant d'emphysème sévère, à Heidelberg, celui-ci est soumis à une tomographie computérisée à haute résolution, puis à une tomodensitométrie quantitative (QCT, Quantitative Computed Tomography). La QCT permet d'analyser l'intégrité des scissures et la distribution de l'emphysème au niveau segmentaire. Pour les patients où la maladie prédomine sur le lobe supérieur, où tous les segments sont plus atteints que le lobe inférieur et qui n'ont pas de ventilation collatérale, une valve ou une opération sont proposées. Les autres patients où la maladie prédomine sur le lobe supérieur se voient proposer l'ablation par vapeur thermique sous bronchoscopie (BTVA) avec InterVapor ou une intervention chirurgicale. Cela inclut à la fois les patients atteints de ventilation collatérale et les patients qui ont un segment du lobe supérieur sain dans le lobe traité. 

Figure 1.  Algorithm presented at ERS 2017, Milan, Italy.
Figure 1. Algorithm presented at ERS 2017, Milan, Italy.

Le professeur Ralf Eberhardt a déclaré : « L'analyse récente des sous-groupes, lors d'une étude contrôlée randomisée STEP-UP BTVA1, montre très clairement que les patients avec ventilation collatérale, présentent une amélioration notable et cliniquement significative des fonctions pulmonaires et de la qualité de vie, avec une proportion très faible de complications médicales graves. Chez ces patients, la BTVA s'est révélée avoir le meilleur profil d'innocuité, ce qui explique pourquoi la BTVA est notre premier choix quant aux patients ayant une ventilation collatérale. En outre, le fait que la BTVA peut cibler la maladie au niveau segmentaire, constitue un avantage pour certains patients en raison de l'aspect particulier de la maladie dans un lobe ciblé. Nous disposons désormais des traitements nous permettant d'évaluer chaque patient et de proposer le traitement le plus efficace en fonction de sa maladie particulière. »

Le système BTVA InterVapor est certifié CE et approuvé à des fins commerciales au sein de l'Union européenne. ATTENTION : le système BTVA InterVapor n'est pas approuvé aux États-Unis.

  1. Gompelmann, D., Eberhardt, R., Schuhmann, M., Valipour, A., Shah, P. L., Herth, F. J. F., & Kontogianni, K. (2016). Lung Volume Reduction with Vapor Ablation in the Presence of Incomplete Fissures: 12-Month Results from the STEP-UP Randomized Controlled Study. Respiration; International Review of Thoracic Diseases, 92(6), 397–403. https://doi.org/10.1159/000452424

Photo - http://mma.prnewswire.com/media/559868/Uptake_Medical_Algorithm_Infographic.jpg

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