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Prof. Dr. med. Ralf Eberhardt stellt Heidelberger Algorithmus zur Selektion von Patienten mit bronchoskopischer Lungenvolumenreduktion bei der ERS 2017 vor
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News provided by

Uptake Medical

Sep 25, 2017, 03:26 ET

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MAILAND, 25. Sept. 2017 /PRNewswire/ -- Bei der jährlichen Versammlung der European Respiratory Society (ERS) letzte Woche in Mailand, Italien, stellte Prof. Dr. med Ralf Eberhardt von der Heidelberger Thoraxklinik den Algorithmus (Abbildung 1) vor, der in der klinischen Praxis zur Auswahl der passenden Methode zur Reduktion des Lungenvolumens auf der Grundlage der gegenwärtig veröffentlichten Daten angewandt wird. Die Lungenvolumenreduktion ist eine Methode zur Behandlung von Emphysem-Patienten in einem fortgeschrittenen Stadium, um deren Lungenfunktion, Belastungstoleranz und Lebensqualität zu verbessern. Nach Diagnose eines Patienten mit schwerem Emphysem werden die Patienten in Heidelberg einer hochauflösenden CT unterzogen, die anschließend zur quantitativen CT-Analyse (QCT) weitergeleitet wird. Die QCT gibt Aufschluss über Fissur-Integrität und Ausbreitung der Emphysemerkrankung auf Segmentebene. Bei Patienten, bei denen hauptsächlich der obere Lungenlappen befallen ist, waren alle Segmente stärker von der Krankheit betroffen als im unteren Lungenlappen und es wurde keine zusätzliche Beatmung in Verbindung mit Beatmungsklappen oder einem chirurgischen Eingriff zur Behandlung angeboten. Den restlichen Patienten mit überwiegendem Krankheitsbefall des oberen Lungenflügels wurde die InterVapor Bronchoscopic Thermal Vapor Ablation (BTVA) [bronchoskopische Thermoablation mit Hilfe von Dampf] oder ein chirurgischer Eingriff angeboten. Dies beinhaltet sowohl CV+-Patienten als auch Patienten mit einem gesunden Segment des oberen Lungenflügels im behandelten Flügel.

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

„Die jüngste Untergruppenanalyse der BTVA STEP-UP RCT1 zeigt sehr deutlich, dass es bei Patienten mit begleitender Beatmung zu einer wesentlichen und klinisch bedeutsamen Verbesserung der Lungenfunktion und Lebensqualität bei einer sehr niedrigen Quote an größeren medizinischen Komplikationen kam. Da die BTVA bei diesen Patienten das beste Effektivitäts-Sicherheits-Verhältnis gezeigt hat, ist die BTVA unsere erste Wahl für Patienten mit begleitender Beatmung. Daneben ist die Tatsache, dass die Krankheit mit der BTVA auf Segmentebene behandelt werden kann aufgrund des vereinzelten Auftretens der Krankheit innerhalb eines bestimmten Lungenflügels ein Vorteil für manche Patienten. Wir haben nun die Behandlungsmethoden, die eine individuelle Betrachtung jedes einzelnen Patienten sowie das Angebot der effektivsten Behandlung je nach individuellem Auftreten der Krankheit ermöglichen", sagt Professor Ralf Eberhardt. 

Das BTVA InterVapor-System ist mit dem CE-Siegel versehen und zum Verkauf in der Europäischen Union zugelassen. ACHTUNG: Das BTVA InterVapor-System ist nicht zur Verwendung in den Vereinigten Staaten zugelassen.

  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

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

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