Bronchial Thermoplasty
Bronchial Thermoplasty is an experimental treatment for asthma where heat created by radio frequency waves, at 149 degrees, (about the temperature of a cup of coffee) is applied to small and medium sized bronchial tubes reducing the amount of smooth muscle in that area. The treatment appears promising and well tolerated so far. Trials appear to have dramatic benefits for those patients with the most severe asthmatics.
This treatment first began as part of research from a Dr. John Miller who is head of the Division of Thoracic Surgery at St. Joseph's Hospital in Ontario, CA. Several years ago while looking for a way to stiffen the lungs of patients with emphysema he found that a procedure he was testing reduced the amount of smooth muscle in the small airways and did little else. It became apparent that bronchial Thermoplasty was better suited for people with asthma.
Clinical trials have been approved by the FDA to determine the safety and efficacy of a system (Alair catheter) to deliver heat with the goal of reducing the amount of smooth muscle surrounding the airways. This reduction in smooth muscle will have the effect of using a bronchodilator such as albuterol, but is longer lasting, possibly permanent. Nearly 300 subjects will be needed for this trial.
Results of a study released May 22, 2006 following 16 asthmatics from other parts of the world who had their condition treated with Bronchial Thermoplasty two years ago demonstrated long lasting benefits to these patients. Improvements in the patients peak flow numbers, quality of life and number of days without symptoms were noted in the study. Source
A bronchial thermoplasty treatment involves three sessions approximately 30 to 60 minutes long. A patient undergoing this procedure will have a bronchoscope inserted into either their nose or mouth and directed into their lungs. A part of this bronghoscope is the the tube which provide the radio frequency waves which reduces the amount of smooth muscle lining the bronchial tubes.
Concerns/Complications about the procedure include:
- An aggrivation of asthma symptoms - several patients have reported a cough and wheezing hours after the procedure has been completed
- Tissue swelling and increased mucus production in the treated airways
- Colapse of the lung tissue structure
- The procedure only works on a limited area of lung tissue. There are concerns that asthma symptoms may become worse further down in the lungs where the procedure cannot reach or that patients may become complacent in taking their meds thinking that they have been cured.
- Cost - Bronchoscopy costs $2000.
View a picture of the Alair system "basket" used for Bronchial Thermoplasty
A list of trial sites in the United States is as follows: Click on a city for more information.
Sources
http://www.stjosham.on.ca/sjhh/innowinter06/Inn_Winter_06_Pg12-23.pdf
http://www.hospitalnews.com/modules/magazines/mag.asp?ID=3&IID=67&AID=904
http://www.clinicaltrials.gov/ct/show/NCT00231114?order=1
http://news.yahoo.com/s/ap/20060523/ap_on_he_me/healthbeat_asthma
http://ryankeeping.tripod.com/id4.html
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Last Updated 5/24/2006 12:10:57 AM
