Bronchial Thermoplasty

What is Bronchial Thermoplasty? 

Bronchial Thermoplasty (BT) is a procedure that is being used to treat those with severe persistent asthma that are not able to control their disease with inhaled corticosteroids and long acting beta agonists. Over 24 million people suffer asthma attacks. For a small group of those Bronchial Thermoplasty offers them a way to control their disease. People with chronic asthma often develop a thickening of the smooth muscle lining the airways. Not only do they have too much muscle, it is too "twitchy". If there are irritants in the airways, they can close down to the size of a pinhole. Most asthma medications work by reducing that "twitchiness".

Bronchial Thermoplasty works by permanently opening constricted airways by reducing the smooth muscle lining and can provide relief for chronic, acute asthmatics. BT is done as an outpatient procedure by a pulmonologist and is a minimally invasive procedure. A thermoplasty device is used through a bronchoscope to deliver heat energy to the airway of the lungs. This reduces excessive muscle and decreases the the airways ability to narrow. Each activation of the device treats less than an inch of airway. The pulmonologist moves the device and activates it again and again along the dozens of bronchial branches. This is the first non-drug treatment for asthma, and it's a very promising technology for patients who have been taking all the medications and whose symptoms are still not completely controlled. 

Asthma patients may breathe easier because of new procedure.

    
Risks: BT has some risks associated with it, mainly lung collapse, bleeding and additional breathing problems, mostly related to the bronchoscope. There are no nerves inside the airways, bronchial thermoplasty isn't painful. Patients generally do feel worse for a day or two following the treatments—one reason the procedure is divided into three separate treatments. There's a lot of mucous to cough up, and the throat may be a little sore from the brochoscope.




In a clinical study with adults who were treated with BT had the following results:

Thermoplasty device in the bronchial airways

• 84% reduction in ER visits for symptoms of asthma
• 73% reduction in hospital visits for symptoms of asthma
• 66% reduction in lost days from work, school, or other activities due to asthma
• 32% reduction in asthma attacks

   Since BT is so new, few insurers cover it yet. The total cost to patients can range from $12,000 to $18,000. But some people with severe asthma pay that much per year for medications, doctor visits and hospital expenses.

The Alair System

  


YouTube video showing how the Alair System is used:
Bronchial Thermoplasty: A Novel Approach to Severe Asthma

The advances in technology are improving Respiratory Care for many patients who struggle each day to breathe. With these advances giving those who suffer a better quality of life, my hope is that it will become more accessible for those who desperately need it.