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197:—a thin, flexible tube-like instrument introduced through the patient’s nose or mouth and into their lungs—delivers thermal energy into the airways. The patient is monitored after the procedure and usually returns home the day of the procedure or early the following day. The catheter delivers a series of 10-second temperature controlled bursts of
230:. The treatment has been shown in prospective studies to be safe and effective with duration up to five years. Bronchial thermoplasty is indicated for the treatment of severe persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long acting beta agonists as per GINA guidelines.
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energy to the airway wall, thus heating the tissue and reducing the amount of smooth muscle present in the airway wall. This reduces the capacity of the immune system to cause bronchoconstriction through nitric oxide signalling, which is the main root cause of asthma symptoms. Bronchial thermoplasty
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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. Reduction in asthma attacks, ER visits, and hospitalizations for respiratory
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In a double-blind, randomized, sham-controlled clinical study of bronchial thermoplasty, 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
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symptoms are maintained to at least 5 years. 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.
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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
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A full course of bronchial thermoplasty treatment 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.
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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:
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energy which heat the lining of the lungs to 65 degrees
Celsius. It is this heat that destroys some of the muscle tissue which constricts during an asthma attack, reducing the number and severity of exacerbations.
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Bronchial thermoplasty was first approved by FDA in April 2010. Bronchial thermoplasty is now being used as a treatment in many countries which include United
Kingdom, India, and United States.
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546:"Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial"
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patients, patients treated with bronchial thermoplasty also experienced the following benefits, although none reached statistical significance:
774:"Apollo Hospitals, Chennai successfully performed Bronchial Thermoplasty on a patient, suffering from severe asthma for over 40 years"
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is normally used to treat patients with severe persistent asthma who do not respond well to typical pharmacotherapy regimens.
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Thomson NC, Rubin AS, Niven RM, Corris PA, Siersted HC, Olivenstein R, et al. (AIR Trial Study Group) (February 2011).
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Have a known sensitivity to medications required to perform bronchoscopy, including lidocaine, atropine and benzodiazepines
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Bronchial thermoplasty is irreversible; the smooth muscle tissue which is destroyed cannot be recovered.
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Wechsler ME, Laviolette M, Rubin AS, Fiterman J, Lapa e Silva JR, Shah PL, et al. (December 2013).
646:"Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma"
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Castro M, Rubin AS, Laviolette M, Fiterman J, De
Andrade Lima M, Shah PL, et al. (January 2010).
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Cox G, Miller JD, McWilliams A, Fitzgerald JM, Lam S (May 2006). "Bronchial thermoplasty for asthma".
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Thomson NC, Rubin AS, Niven RM, Corris PA, Siersted HC, Olivenstein R, et al. (February 2011).
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595:"Long-term (5 year) safety of bronchial thermoplasty: Asthma Intervention Research (AIR) trial"
495:"Long-term (5 year) safety of bronchial thermoplasty: Asthma Intervention Research (AIR) trial"
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66% reduction in days lost from work, school, or other daily activities due to asthma symptoms
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Mayse ML, Laviolette M, Rubin AS, Lampron N, Simoff M, Duhamel D, et al. (April 2007).
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776:. Apollo Hospitals Southern Region. 20 February 2018. Archived from
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695:"Recent Developments In Bronchial Thermoplasty For Severe Asthma"
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84% reduction in emergency room visits for respiratory symptoms
745:"Asthmatx, Inc. Alair Bronchial Thermoplasty System - P080032"
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15:
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American
Journal of Respiratory and Critical Care Medicine
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American
Journal of Respiratory and Critical Care Medicine
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73% reduction in hospitalizations for respiratory symptoms
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in 2010 involving the delivery of controlled, therapeutic
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Have previously been treated with bronchial thermoplasty
428:"Global Strategy for Asthma Management and Prevention"
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46:. Unsourced material may be challenged and removed.
747:. U.S. Food and Drug Administration. 2010-05-19.
760:"UK doctors begin pioneering asthma treatment"
650:The Journal of Allergy and Clinical Immunology
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454:"Clinical Pearls for Bronchial Thermoplasty"
299:. Unsourced material may be challenged and
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319:Learn how and when to remove this message
106:Learn how and when to remove this message
222:has demonstrated almost no capacity for
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375:"Bronchial Thermoplasty – Pulmonology"
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297:adding citations to reliable sources
193:Under sedation, a catheter inside a
181:Animation of bronchial thermoplasty
44:adding citations to reliable sources
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226:, and it is instead replaced with
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243:32% reduction in asthma attacks
31:needs additional citations for
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758:Ravenscroft N (8 June 2011).
699:Journal of Asthma and Allergy
471:10.1097/LBR.0b013e318054dbed
432:Global Initiative for Asthma
218:and nerves; however, airway
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662:10.1016/j.jaci.2013.08.009
562:10.1164/rccm.200903-0354OC
406:10.1164/rccm.200507-1162OC
151:is a treatment for severe
693:Thomson NC (2019-11-19).
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379:www.bostonscientific.com
55:"Bronchial thermoplasty"
612:10.1186/1471-2466-11-8
599:BMC Pulmonary Medicine
512:10.1186/1471-2466-11-8
499:BMC Pulmonary Medicine
458:Journal of Bronchology
353:Procedure Availability
336:Are under 18 years old
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803:Respiratory therapy
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762:. BBC News.
705:: 375–387.
131:pulmonology
792:Categories
438:2018-05-21
434:: 48. 2018
361:References
208:epithelium
66:newspapers
309:June 2019
280:does not
168:Procedure
127:Specialty
96:July 2022
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234:Benefits
183:catheter
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261:Risks
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