Interventional pulmonologist brings rare skills to UTHSC
A man stumbles into the Audie L. Murphy Veterans Administration Hospital, pleading for another breath of air, gasping for another chance at life. His eyes bulge, his throat constricts — he chokes on the tumor that has forced its way through his lungs.
Under ordinary circumstances, this man would have died. Instead, he received the best treatment possible — care from Dr. Luis Angel.
Dr. Angel is an interventional pulmonologist, one of only a handful in the country and the only one in South Texas. Dr. Angel also is the newest member of the Health Science Center faculty.
Like a pulmonologist, Dr. Angel is trained to examine the lungs and airways. Unlike a pulmonogist, he doesn't just assess the problem, he performs interventional procedures in the airways as well as in the chest cavity to improve the quality of life of very sick patients.
"In the past, we were able to just look into the patient's trachea and lungs and make the diagnosis. That was about all we were able to do. It was frustrating," Dr. Angel said. "As an interventional pulmonologist, I can use a LASER, cryotherapy, stents, rigid bronchoscopy and so on to actually get rid of the tumor obstruction when I see it. With this patient at the VA, we were able to remove his tumor. After a few days he left the hospital breathing freely on his own."
Interventional pulmonogists mostly work with patients with cancer, tracheal stenosis, complicated pleural effusions or those who have had lung transplants. They also treat a few cases of tracheomalasia, a condition in which the trachea collapses.
Not only can the interventional pulmonologist perform life-saving procedures immediately after diagnosing a problem, the practice saves many patients from major surgery. "We can do a medical thoracoscopy, in which we look inside of the patient's chest with a lens, on patients with fluid in the pleural space. Until recently this procedure has required a general anesthesia. Now, we can do thoracoscopy while the patient is awake, using a local anesthesia."
The field of interventional pulmonolgy is relatively new. Only two institutions in the United States have formal training programs in this specialty. Dr. Angel hopes the Health Science Center will become a training center for fellows in this field. "This field gives cancer patients another option. We can help them breathe a little easier, keep their airways open and give them a few more months of a good life."
Dr. Angel completed a medical residency and a pulmonary and critical care fellowship before training for his specialty at Harvard Medical School's Beth Israel Deaconess Hospital. He is an assistant professor in the department of medicine and works in the division of pulmonary and critical care and in cardiothoracic surgery.