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Bronchial Thermoplasty

Asthma is a chronic inflammatory condition of the airways with periodic symptoms of breathlessness, coughing and wheezing. Chronic airway inflammation can lead to an increase in the thickness of airway smooth muscle (ASM), causing airflow constriction and difficulty breathing — common symptoms during an allergy attack.

In 2010, the FDA approved a breakthrough treatment for severe or persistent asthma called bronchial thermoplasty. This procedure reduces the amount of ASM in the airway by delivering controlled, therapeutic radiofrequency energy to the airway walls, heating and breaking down the muscle tissue, and thus lessening the occurrence of asthma symptoms.

Some patients with severe asthma may find improvement in their condition with bronchial thermoplasty, an outpatient procedure clinically proven to reduce asthma attacks for up to five years. During an asthma attack, an excess of smooth muscle constricts the airways, making breathing difficult. Bronchial thermoplasty, an advanced outpatient procedure, may offer relief to some patients.

Bronchial thermoplasty, or BT, reduces the amount of excess muscle and helps minimize the narrowing of airways during an asthma attack. This procedure uses mild heat to reduce the excessive smooth muscle in the airways, helping to reduce severe asthma attacks. BT does not replace daily maintenance medication, but instead works with medication to provide long-term stability of asthma symptoms and lessen severe asthma attacks requiring oral steroids.

Benefits and Risks

In a clinical trial, nearly 79 percent of patients treated with BT reported significant improvements in their asthma-related quality of life, including:

  • A reduction of asthma attacks
  • Reduced emergency department visits and
  • hospitalizations for respiratory symptoms
  • Fewer days lost from work, school and other daily activities

As with any procedure, there may be risks and patients may experience different levels of effectiveness. The most common side effect of BT is temporary worsening of respiratory-related symptoms, usually within one to seven days. There is a small risk these symptoms may require hospitalization.

Candidate Assessment

BT is approved by the Food and Drug Administration (FDA) for treatment of severe asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long-acting beta-agonists. Evaluation by one of our highly trained pulmonologists will determine a patient’s suitability for this procedure. Additionally, our staff will work to request coverage of the procedure by the patient’s insurance company.

Treatment

BT is typically performed under moderate sedation in three separate sessions scheduled three weeks apart. Each session lasts about an hour and focuses on a different part of the lung to ensure all affected areas are treated.

No incision is required as a bronchoscope is inserted into the patient’s mouth or nose and guided to the lungs. A special medical device on the end of the bronchoscope delivers mild heat to the excessive smooth muscle in the lungs.

After the procedure, patients are monitored for two to four hours and discharged the same day.