RADIOLOGIC EVALUATION OF EMPHYSEMA FOR LUNG VOLUME REDUCTION SURGERY - 08/09/11
Résumé |
Lung volume reduction surgery (LVRS) is a recent addition to the treatment options for selected patients with pulmonary emphysema, a condition affecting approximately 1.65 million people in the United States.81 Emphysema, asthma, and chronic bronchitis are three forms of chronic obstructive pulmonary disease (COPD), each characterized to some degree by shortness of breath and airflow limitation. Whereas asthma is a reversible condition characterized by bronchospasm, and chronic bronchitis is accompanied by a productive cough, these three forms of obstructive lung disease often overlap in the same patient.81 Emphysema, specifically, is a chronic, slowly progressive disease, defined by the American Thoracic Society as “a condition of the lung characterized by abnormal, permanent enlargement of the air spaces distal to the terminal bronchiole, accompanied by destruction of their walls.”80 Some forms of emphysema, such as ⍺1-antiprotease deficiency are inherited, but most pulmonary emphysema develops secondary to cigarette smoking. This chronic and irreversible illness is the source of considerable patient morbidity and medical expense, through medical therapy, supplemental oxygen therapy, pulmonary rehabilitation, and hospitalization for disease exacerbation and superimposed infections.
Approximately two thirds of the nearly 12,000 patients requiring daily mechanical ventilator support via tracheostomy for respiratory failure in the United States each year have COPD as the etiology, at a yearly cost of $2 billion.38 Once requiring mechanical ventilation, the prognosis for patients with COPD is significantly worse than that for patients with other causes of respiratory failure.94
Until the advent of LVRS, lung transplantation was the only treatment available to patients with severe emphysema failing medical therapy. Unfortunately, because of the limited availability of lung allografts and frequency of chronic allograft rejection, this is not a viable option for many patients. 32, 88
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| Address reprint requests to Ella A. Kazerooni, MD, Department of Radiology/2910Q Taubman Center, University of Michigan Medical Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109–0326, e-mail: ellakaz@umich.edu |
Vol 20 - N° 4
P. 845-861 - décembre 1999 Retour au numéro
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- IMAGING OF LUNG TRANSPLANTATION
- Jo-Anne O. Shepard
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