Connections: December 2023 - 5

>>A gift of hope
Two new procedures offer patients possibilities
Detecting lung cancer
early through yearly screening can
reduce lung cancer-related mortality
rates by 20 percent. Through the use
of robotic bronchoscopy-a robotic
technology that enables specialists to
biopsy patients with smaller growths
in the lungs and sample lymph
nodes during the same procedure-
Dartmouth Health is seeing diagnostic
yields that are higher than the national
average. Increases in successful lung
biopsy procedures translate into
improved patient outcomes. Physicians
are more likely to catch cancer earlier
and begin treatment sooner, which can
make a significant improvement in a
patient's prognosis.
When Dartmouth Health adopted
robotic bronchoscopy in April 2022,
it was the first in New Hampshire or
Maine to do so. The Interventional
Pulmonology team has performed
more than 200 procedures using the
platform since then.
" The chances of finding and
sampling a small nodule in the lung
are better than perhaps ever before, "
says Elliot D. Backer, MD, director
of Interventional Pulmonology at
Dartmouth Health's Dartmouth
Hitchcock Medical Center (DHMC).
" Before adopting the robotics
platform, this was very hard to do.
Now, we can more safely and more
accurately diagnose patients at an
earlier stage than was previously
possible. "
" One of the many benefits of being
an academic health system means
Dartmouth Health is at the forefront
of the latest procedures, technologies
and treatments, " says David J.
Feller-Kopman, MD, section chief of
Pulmonary and Critical Care Medicine
at DHMC. " That can make a big
difference when it comes to patient
outcomes. "
Interventional pulmonologists David J.
Feller-Kopman, MD (left), and Elliot D. Backer,
MD, performing a lung nodule biopsy using
the Ion robotic bronchoscope platform.
As part of the multidisciplinary
Comprehensive Thoracic Oncology
Program (CTOP) at Dartmouth Cancer
Center, Backer and Feller-Kopman are
New Hampshire's only interventional
pulmonologists. When a diagnosis
is made, a patient's case is reviewed
by Dartmouth Health's thoracic
surgeons and cancer specialists
to provide prompt, state-of-the art,
multidisciplinary care.
An angiogram image
shows the leg of a
patient who had the
LimFlow procedure,
restoring blood flow
to their foot.
(Photo: LimFlow)
New England, and just 25 nationally.
LimFlow is a minimally invasive
Patients with diabetes
are sometimes faced with chronic limbthreatening
ischemia (CLTI), which can
result in amputation of the foot. A new
procedure available at the Heart and
Vascular Center at DHMC offers new
hope in preserving limbs. DHMC is the
only hospital in northern New England
to offer LimFlow, only one of two in all
technology designed to divert blood
around diseased arteries in the leg
and into the tibial veins that feed the
foot, bringing blood and oxygen to
starved tissues. The procedure works
by implanting a stent in the patient's
leg that permanently bypasses
arteries that are blocked and cannot
be reconstructed. An abundance of
oxygen in the tissue can immediately
relieve pain and promote healing of
chronic wounds for many patients,
improving their quality of life.
DHMC patient Robert McBride, 72,
of Bellows Falls, VT, has lived with
type 1 diabetes for 58 years and grew
concerned when a small wound on his
left big toe was failing to heal. When
hyperbaric treatment was ineffective,
McBride's vascular surgeon, Jocelyn M.
Beach, MD, recommended he have the
LimFlow procedure.
" The wound was just getting worse
to the point that it almost hit bone in
my toe, " McBride says. " While Dr. Beach
did have to amputate my toe, had I not
had the LimFlow procedure, I probably
would have lost my entire left foot
eventually. I received truly outstanding
care and attention to my issue from
the team at DHMC, and this procedure
really changed my life. "
" Amputation is a drastic measure, but
before procedures like LimFlow, it was
often the only option for patients like
Mr. McBride, " says Beach, who serves as
principal investigator of a clinical trial of
LimFlow at DHMC. " The ability to offer
this treatment to our patients at DHMC
gives tremendous potential to preserve
and even improve their quality of life. "
Connections: December 2023

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