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Bronchial Thermoplasty

Good Samaritan Hospital (GSH) offers an innovative procedure called bronchial thermoplasty for the treatment of severe asthma. Bronchial thermoplasty is an outpatient bronchoscope procedure that has been shown to decrease severe asthma attacks and improved quality of life.

GSH is the first and only hospital in the Dayton region to offer this non-drug procedure. 

Three physicians are performing bronchial thermoplasty at GSH: 

These pulmonologists are skilled in bronchoscopy and specially trained to perform this procedure.

A Promising New Treatment 

For an estimated two million adults with severe asthma, who continue to have asthma-related symptoms despite standard of care medications, bronchial thermoplasty is a new treatment option.

“I can now offer some patients an alternative to inhaled corticosteroids and long-acting beta-agonists to treat their severe asthma,” said Dr. Rajesh C. Patel, MD.

“For those life-long, asthma-suffering patients that are candidates for bronchial thermoplasty, it can provide a life-changing positive outcome,” he said. “Being able to breathe makes what most people take for granted possible for some, whether it is walking up a flight of stairs or playing in the backyard with children or grandchildren. Bronchial thermoplasty can make a difference.”

What is Bronchial Thermoplastey?

Bronchial thermoplasty is an outpatient procedure that treats severe asthma by going to the source of the problem. The lungs consist of multiple airway passages surrounded by airway-smooth muscle. For people with asthma, this airway-smooth muscle is more susceptible to triggers and irritants that can cause it to constrict and reduce the amount of air that flows through the lungs. 

This procedure uses a small catheter (thin flexible tube) to deliver controlled energy to the airways of the lung to reduce the amount of excessive airway-smooth muscle. This reduction decreases the muscle’s ability to constrict the airways, resulting in a decreased frequency of asthma attacks.

Bronchial thermoplasty with the Alair® System is the first non-drug procedure approved by the FDA for adults with severe asthma who are not well controlled on current medications. It is expected to complement asthma medications by providing long-lasting asthma control. 

The procedure is routinely performed under moderate sedation and the patient goes home the same day. To treat the entire lung, the complete bronchial thermoplasty procedure is performed in three separate outpatient treatment sessions, each treating a different area of the lung and scheduled approximately three weeks apart.

In clinical studies, the benefits of bronchial thermoplasty included: 

  • Reduced severe asthma attacks
  • Decreased visits to the emergency room and hospital for respiratory symptoms
  • Less time lost from work or school due to asthma

Adults suffering from severe asthma should talk with their physician to determine if bronchial thermoplasty is right for them. 

What to Expect with Bronchial Thermoplasty

Who qualifies for this treatment?

People who have severe asthma. Asthma is considered severe if the asthma drugs you are taking do not control your asthma symptoms.

What is bronchial thermoplasty?

With this procedure, a device mildly heats your airway walls. The heating reduces some of the extra muscle present in the airways. This allows your airways to open and helps you breathe better.

Who should have this treatment?

This treatment is for those 18 years and older who have severe, persistent asthma and whose asthma is not well controlled with inhaled corticosteroids and long-acting beta agonists.

Who cannot have this treatment?

You cannot have this treatment if you

  • Have an implant with electronics, such as a pacemaker. The bronchial thermoplasty may keep the implant from working correctly.
  • Have problems taking certain medicines. If you have ever had a problem taking any kind of medicines, your doctor needs to ensure that the medicine used in the procedure will not harm you.
  • Have had this treatment before. Tell your doctor if you have already had bronchial thermoplasty.
  • Are less than 18 years old. No one has tested bronchial thermoplasty in patients younger than age 18.

What happens if you decide to have the bronchial thermoplasty treatment for your severe asthma?

There are three treatments with three weeks in between each treatment.

  • You will prepare for each treatment by taking 50-mg steroid pill by mouth once a day for three days before the treatment.
  • You will also take a 50-mg steroid pill on the day of the treatment.
  • On each bronchial thermoplasty treatment day, your doctor will test your lungs to see how much air you can blow out (exhale).
  • Your doctor will make sure you do not have an infection. An infection would delay the treatment.
  • Your doctor will explain what to expect during the bronchial thermoplasty.

During the procedure your doctor will:

  1. Give you medicines to make you sleepy.
  2. Put a small tube called a bronchoscope through your mouth, into your airways.
  3. Put a small tube through the bronchoscope. The wires on its end will touch your airways.
  4. Heat the wires on the end of the small tube to reduce some of the airway muscle tissue. You won’t feel this because your doctor will have sedated you.
  5. Move the small tube to more places and treat them the same way.
  6. Take the small tube and the bronchoscope out.
  7. Monitor you as you wake up and recover.

What happens after each bronchial thermoplasty treatment?

  • You take a 50-mg steroid pill for the day.
  • Your doctor contacts you by phone to check on you.
  • You continue to take your asthma medicine.
  • You use your rescue inhaler if your asthma symptoms get bad. Tell your doctor if you needed to use your rescue inhaler.

After your airways heal from your first treatment, you go back to your doctor for your second treatment. Your doctor treats more of your airways. After you heal from that procedure, your doctor treats the rest of your airways in your third treatment.

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