ECU Physician First to Use Device to Open Airway
By Doug Boyd
A 55-year-old New Bern woman with cancer was the first U.S. patient to receive a new device designed to help keep her airway open during a procedure last Thursday in Greenville.
Dr. Gordon Downie, a pulmonologist and associate professor of medicine at the Brody School of Medicine at East Carolina University, inserted a new type of tracheobronchial stent in the patient, who has a cancerous tumor in her bronchial tube. That tumor blocked approximately 40 percent of her airway, Downie said. After the stent placement, only about 10 percent of her airway remained blocked, he added.
Downie said the procedure helps patients breathe more easily even though it doesn’t directly treat the cancer.
“This is a palliative procedure (for) patients who are beyond a cure and you’re looking to make the symptoms better,” Downie said. “I think this procedure can definitely improve quality of life.”
A stent is a tubular device made of an alloy metal such as nickel or titanium. It is compressed onto a delivery device and delivered to the area of the trachea, bronchial main stem or branch stem where the narrowing is. The physician then releases the stent, and it springs open, propping open the airway so the patient can breathe more easily. Stents can also be coated with a film that prevents tumor growth into the airway. Placing the stent takes approximately 15 minutes, Downie said, and does not require general anesthesia.
This improved stent, made by Charlotte-based Alveolus and called the Aero Tracheobronchial Stent, has a collagen coating that reduces the formation of scar tissue around it that could renarrow the airway, Downie said. The Aero stent has been used successfully in Europe and is undergoing trials in the United States, according to Alveolus. Downie’s use of it Thursday was the first in those trials.
“Probably about half of lung cancer patients could benefit from this at some point,” Downie said. He already uses stents in 80 to 100 patients yearly, he added. The new stent should reduce the number of patients whose airways re-narrow due to scar tissue formation. “In some cases there will be a dramatic improvement in symptoms,” he said. “In other cases, the effect is that there is not a dramatic decline.”
The devices are similar to stents used to open blood vessels, but are much larger. The trachea is approximately 2 centimeters in diameter, Downie said, while the right and left main stems are 14-16 millimeters and the branches from those are 8-10 millimeters. The stent he used Thursday was 14 millimeters in diameter and 4 centimeters long.
The New Bern patient has cervical cancer that has spread to her lungs. The tumor the stent was applied to is in her left main bronchial stem. The procedure was done at Pitt County Memorial Hospital, the teaching hospital of the Brody School of Medicine at ECU. Downie also sees patients at the Leo W. Jenkins Cancer Center.
This page originally appeared in the July 15, 2005 issue of Pieces of Eight. Complete issue is archived at http://www.ecu.edu/news/poe/archives.cfm.