Interventional pulmonologists at Emory University Hospital are now offering Bronchial Thermoplasty, a new procedure that shrinks excessive airway smooth muscle (ASM) that lines the bronchial airways using controlled thermal heat. Removing some of the airway smooth muscle decreases the ability of the airways to constrict, leading to a reduction in the amount and severity of asthma attacks.
Patients with severe persistent asthma experience frequent symptoms such as coughing, wheezing, shortness of breath, chest tightness, mucus production and severe asthma attacks, leading to a diminished quality of life. These symptoms account for a substantial portion lost work days, frequent physician office visits, emergency room visits, extended hospitalizations, and missed school or other daily activities.
“Many symptoms of asthma are thought to be due to the contraction of airway smooth muscle, leading to a constriction or narrowing of the bronchial air path. Increased airway smooth-muscle mass is a characteristic feature of asthma, particularly in persons with severe asthma,” says Rabih Bechara, MD, director of interventional pulmonology and assistant professor of medicine, Emory School of Medicine. “Bronchial thermoplasty is a novel intervention where thermal heat energy is delivered to the airway wall during a series of bronchoscopies, resulting in a prolonged reduction of airway smooth-muscle mass.”
Bronchial thermoplasty is performed under anesthetic in three outpatient procedure visits, each scheduled approximately three weeks apart. The first procedure treats the airways of the right lower lobe, the second treats the airways of the left lower lobe and the third and final procedure treats the airways in both upper lobes.
During the minimally-invasive procedure, a thin, flexible instrument called a bronchoscope is inserted into the airway. The bronchoscope is a long flexible tube that has a camera on one end, and also allows the physician to see inside the lungs without an incision. Once inserted, the thermal heat energy is delivered to the airway smooth muscle, shrinking it, and, in effect, further opening the airway for improved breathing function.
The procedure is FDA-approved and, although still a relatively new procedure, it has proven successful for patients suffering from severe asthma. Currently, however, the procedure is not yet covered by Medicare or through most major insurance providers – although physicians expect that will change as success of the procedure continues to show a reduction in hospitalizations and other ongoing care related to severe asthmatic symptoms
“Thermoplasty has proven to decrease asthma exacerbation rates and lower rescue inhaler use. We have seen a much improved quality of life in the patients we have treated,” says David Berkowitz, MD, assistant professor of medicine at Emory. “The procedures are done on an outpatient basis. Most patients experience very minor discomfort and can quickly return to work or other normal activities within a day. The overall reduction in breathing discomfort, lost work or school days, and general disruption of normal life activities has been evident in most of the patients we treat.”
Learn more about bronchial thermoplasty by visiting Bronchial Thermoplasty