Asthma is a chronic lung disease that can cause the airways to narrow so that less oxygen flows into the lungs. Uncontrolled asthma is serious, as it can cause permanent damage to the airways. Symptoms are wheezing, tightness in the chest, coughing, and shortness of breath.
Asthma is one of the most common chronic medical conditions in the United States. Data from the 2012 Delaware Behavioral Risk Factor Survey (BRFS) shows nearly 70,000 Delaware adults have been diagnosed at one time with asthma. And, it is among the most common diagnoses of people who have been treated in hospital emergency rooms in Delaware.
There is no cure for asthma, but there are medications that can help manage it. But for many people, these medications do not always control the asthma attacks that can send them to the hospital.
Bronchial Thermoplasty (BT)
Bronchial thermoplasty (BT) can be a treatment option for those who suffer severe attacks. It is not a cure and patients will still need to use their medications. It also has no effect on the patient’s allergies. However, studies are showing that it decreases the number and severity of asthma attacks. A five-year clinical trial demonstrated that 32 percent of patients who finished the trial had fewer severe attacks, 66 percent had fewer missed days of work, and 84 percent had a reduction in emergency room visits than they had during the year before the treatment. The results were reported in the December 2013 issue of the Journal of Allergy and Clinical Immunology.
I have been performing this procedure for nearly two years and I have been following my patients closely. Overall, they are experiencing fewer severe asthma attacks and are telling me that their quality of life has improved.
How Does Bronchial Thermoplasty Work?
Bronchial thermoplasty is performed by a pulmonologist who also has been trained and certified in this procedure. He or she is supported by a team that includes a nurse practitioner, one or two respiratory therapists, and an anesthesiologist. The patient is deeply sedated. There is no incision. Instead, the pulmonologist uses a bronchoscopy to insert a radiofrequency device into the patient’s airways. This device gently heats the smooth muscle in the airways to lessen the muscle volume and hence the constriction. The procedure takes about 30 minutes. Following the procedure, the patient is monitored for two to four hours and usually goes home the same day. The procedure includes three sessions that take place a few weeks apart.
As with any procedure, there are risks, and individual results may vary. The most common side effect of bronchial thermoplasty is temporary worsening of respiratory-related symptoms. There is a 3.4 percent risk per procedure that these adverse symptoms will require hospitalization.
Asthma is a serious health condition that affects the lives of nearly 25 million people in the United States. Luckily, we have many medications and treatments that help most people control their symptoms. And generally, we like to treat people in the most conservative way possible. However, there are those chronic patients who suffer severe and debilitating attacks several times a year, and often with no warning. For them, this new procedure may offer some hope.
Vikas Batra, MD, is a pulmonologist on the Beebe Medical Staff. He is Board Certified in internal medicine, pulmonary medicine, sleep, and critical care medicine. He also is fellowship-trained in pulmonary, critical care, and sleep medicine, and is certified to perform the bronchial thermoplasty procedure. He sees patients at Sussex Pulmonary & Endocrine Consultants in Lewes.