Bronchial thermoplasty
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Bronchial thermoplasty | |
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Specialty | pulmonology |
Bronchial thermoplasty
Procedure
A full course of bronchial thermoplasty treatment[4] includes three separate bronchoscopic procedures: one for the each lower lobe of the lung and another for both upper lobes. Each outpatient procedure is performed approximately three weeks apart.
Under sedation, a catheter inside a
Through a standard bronchoscopy procedure, a small flexible tube is advanced into the airway, via mouth or nose, to mildly heat the airway walls. This treatment has been shown to result in acute epithelial destruction with regeneration observed in the
Benefits
In a double-blind, randomized, sham-controlled clinical study of bronchial thermoplasty,[6] adults with severe asthma treated with bronchial thermoplasty had improved asthma-related quality of life out to a year compared to the control (sham-treated) patients. Additionally, when compared to control patients, patients treated with bronchial thermoplasty also experienced the following benefits, although none reached statistical significance:
- 32% reduction in asthma attacks
- 84% reduction in emergency room visits for respiratory symptoms
- 66% reduction in days lost from work, school, or other daily activities due to asthma symptoms
- 73% reduction in hospitalizations for respiratory symptoms
In a clinical study, bronchial thermoplasty has been proven to provide long-term reduction in asthma induced breathing difficulty to at least 5 years and improve the quality of life for severe persistent asthma patients.[7] Reduction in asthma attacks, ER visits, and hospitalizations for respiratory symptoms are maintained to at least 5 years.[8] These benefits were observed during clinical studies where patients continued to take their standard maintenance asthma medications which included combinations of inhaled corticosteroids and long-acting bronchodilators.
Risks
In the period immediately following the bronchial thermoplasty procedure, there was an expected transient increase in the frequency and worsening of respiratory-related symptoms. Bronchial thermoplasty is not appropriate for patients who:[9]
- Are under 18 years old
- Have a pacemaker, internal defibrillator, or other implantable electronic device
- Have a known sensitivity to medications required to perform bronchoscopy, including lidocaine, atropine and benzodiazepines
- Have previously been treated with bronchial thermoplasty
Bronchial thermoplasty is irreversible; the smooth muscle tissue which is destroyed cannot be recovered.
Procedure Availability
Bronchial thermoplasty was first approved by FDA in April 2010.[10] Bronchial thermoplasty is now being used as a treatment in many countries which include United Kingdom,[11] India,[12] and United States.
References
- ^ "Bronchial Thermoplasty – Pulmonology". www.bostonscientific.com.
- PMID 16456145.
- ^ "Global Strategy for Asthma Management and Prevention". Global Initiative for Asthma: 48. 2018. Retrieved 2018-05-21.
- S2CID 56733680.
- PMID 21314924.
- PMID 19815809.
- PMID 21314924.
- PMID 23998657.
- PMID 31819539.
- ^ "Asthmatx, Inc. Alair Bronchial Thermoplasty System - P080032". U.S. Food and Drug Administration. 2010-05-19.
- ^ Ravenscroft N (8 June 2011). "UK doctors begin pioneering asthma treatment". BBC News.
- ^ "Apollo Hospitals, Chennai successfully performed Bronchial Thermoplasty on a patient, suffering from severe asthma for over 40 years". Apollo Hospitals Southern Region. 20 February 2018. Archived from the original on 2018-03-19.