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Bronchial thermoplasty

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184: 185: 282: 33: 186: 188: 208:—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 241:. 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. 174:
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.
755: 557:"Effectiveness and safety of bronchial thermoplasty in the treatment of severe asthma: a multicenter, randomized, double-blind, sham-controlled clinical trial" 385: 250:
patients, patients treated with bronchial thermoplasty also experienced the following benefits, although none reached statistical significance:
785:"Apollo Hospitals, Chennai successfully performed Bronchial Thermoplasty on a patient, suffering from severe asthma for over 40 years" 97: 69: 303: 50: 438: 175:
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).
657:"Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma" 555:
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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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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Have a pacemaker, internal defibrillator, or other implantable electronic device
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84% reduction in emergency room visits for respiratory symptoms
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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
603: 503: 439:"Global Strategy for Asthma Management and Prevention" 57:. Unsourced material may be challenged and removed. 800: 758:. U.S. Food and Drug Administration. 2010-05-19. 771:"UK doctors begin pioneering asthma treatment" 661:The Journal of Allergy and Clinical Immunology 648: 465:"Clinical Pearls for Bronchial Thermoplasty" 768: 548: 396: 310:. Unsourced material may be challenged and 731: 721: 680: 631: 621: 580: 531: 521: 480: 363: 330:Learn how and when to remove this message 117:Learn how and when to remove this message 233:has demonstrated almost no capacity for 182: 703: 14: 801: 386:"Bronchial Thermoplasty – Pulmonology" 308:adding citations to reliable sources 275: 204:Under sedation, a catheter inside a 192:Animation of bronchial thermoplasty 55:adding citations to reliable sources 26: 24: 237:, and it is instead replaced with 25: 825: 280: 31: 777: 762: 748: 254:32% reduction in asthma attacks 42:needs additional citations for 697: 597: 497: 456: 431: 378: 13: 1: 769:Ravenscroft N (8 June 2011). 710:Journal of Asthma and Allergy 371: 482:10.1097/LBR.0b013e318054dbed 443:Global Initiative for Asthma 229:and nerves; however, airway 178: 7: 244: 10: 830: 673:10.1016/j.jaci.2013.08.009 573:10.1164/rccm.200903-0354OC 417:10.1164/rccm.200507-1162OC 162:is a treatment for severe 704:Thomson NC (2019-11-19). 146: 136: 131: 390:www.bostonscientific.com 271: 66:"Bronchial thermoplasty" 623:10.1186/1471-2466-11-8 610:BMC Pulmonary Medicine 523:10.1186/1471-2466-11-8 510:BMC Pulmonary Medicine 469:Journal of Bronchology 364:Procedure Availability 347:Are under 18 years old 197: 160:Bronchial thermoplasty 132:Bronchial thermoplasty 191: 304:improve this section 51:improve this article 814:Respiratory therapy 723:10.2147/JAA.S200912 198: 340: 339: 332: 239:connective tissue 189: 157: 156: 127: 126: 119: 101: 16:(Redirected from 821: 793: 792: 781: 775: 774: 766: 760: 759: 752: 746: 745: 735: 725: 701: 695: 694: 684: 667:(6): 1295–1302. 652: 646: 645: 635: 625: 601: 595: 594: 584: 552: 546: 545: 535: 525: 501: 495: 494: 484: 460: 454: 453: 451: 450: 435: 429: 428: 400: 394: 393: 382: 335: 328: 324: 321: 315: 284: 276: 190: 166:approved by the 150:edit on Wikidata 129: 128: 122: 115: 111: 108: 102: 100: 59: 35: 27: 21: 829: 828: 824: 823: 822: 820: 819: 818: 799: 798: 797: 796: 783: 782: 778: 767: 763: 754: 753: 749: 702: 698: 653: 649: 602: 598: 553: 549: 502: 498: 461: 457: 448: 446: 437: 436: 432: 401: 397: 384: 383: 379: 374: 366: 336: 325: 319: 316: 301: 285: 274: 247: 210:radio frequency 183: 181: 153: 123: 112: 106: 103: 60: 58: 48: 36: 23: 22: 15: 12: 11: 5: 827: 817: 816: 811: 795: 794: 791:on 2018-03-19. 776: 761: 747: 696: 647: 596: 567:(2): 116–124. 547: 496: 475:(2): 115–123. 455: 430: 395: 376: 375: 373: 370: 365: 362: 358: 357: 354: 351: 348: 338: 337: 288: 286: 279: 273: 270: 265: 264: 261: 258: 255: 246: 243: 180: 177: 172:radiofrequency 155: 154: 147: 144: 143: 140: 134: 133: 125: 124: 39: 37: 30: 9: 6: 4: 3: 2: 826: 815: 812: 810: 807: 806: 804: 790: 786: 780: 772: 765: 757: 751: 743: 739: 734: 729: 724: 719: 715: 711: 707: 700: 692: 688: 683: 678: 674: 670: 666: 662: 658: 651: 643: 639: 634: 629: 624: 619: 615: 611: 607: 600: 592: 588: 583: 578: 574: 570: 566: 562: 558: 551: 543: 539: 534: 529: 524: 519: 515: 511: 507: 500: 492: 488: 483: 478: 474: 470: 466: 459: 444: 440: 434: 426: 422: 418: 414: 410: 406: 399: 391: 387: 381: 377: 369: 361: 355: 352: 349: 346: 345: 344: 334: 331: 323: 313: 309: 305: 299: 298: 294: 289:This section 287: 283: 278: 277: 269: 262: 259: 256: 253: 252: 251: 242: 240: 236: 232: 231:smooth muscle 228: 224: 223:blood vessels 220: 214: 211: 207: 202: 195: 176: 173: 169: 165: 161: 151: 145: 141: 139: 135: 130: 121: 118: 110: 99: 96: 92: 89: 85: 82: 78: 75: 71: 68: –  67: 63: 62:Find sources: 56: 52: 46: 45: 40:This article 38: 34: 29: 28: 19: 789:the original 779: 764: 750: 713: 709: 699: 664: 660: 650: 613: 609: 599: 564: 560: 550: 513: 509: 499: 472: 468: 458: 447:. 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BBC News. 716:: 375–387. 142:pulmonology 803:Categories 449:2018-05-21 445:: 48. 2018 372:References 219:epithelium 77:newspapers 320:June 2019 291:does not 179:Procedure 138:Specialty 107:July 2022 742:31819539 691:23998657 642:21314924 591:19815809 542:21314924 516:(1): 8. 491:56733680 425:16456145 245:Benefits 194:catheter 733:6875488 682:4114404 633:3045390 582:3269231 533:3045390 312:removed 297:sources 91:scholar 809:Asthma 740:  730:  689:  679:  640:  630:  589:  579:  540:  530:  489:  423:  227:mucosa 164:asthma 93:  86:  79:  72:  64:  616:: 8. 487:S2CID 272:Risks 148:[ 98:JSTOR 84:books 738:PMID 687:PMID 638:PMID 587:PMID 538:PMID 421:PMID 295:any 293:cite 70:news 728:PMC 718:doi 677:PMC 669:doi 665:132 628:PMC 618:doi 577:PMC 569:doi 565:181 528:PMC 518:doi 477:doi 413:doi 409:173 306:by 196:use 168:FDA 53:by 805:: 736:. 726:. 714:12 712:. 708:. 685:. 675:. 663:. 659:. 636:. 626:. 614:11 612:. 608:. 585:. 575:. 563:. 559:. 536:. 526:. 514:11 512:. 508:. 485:. 473:14 471:. 467:. 441:. 419:. 407:. 388:. 225:, 221:, 744:. 720:: 693:. 671:: 644:. 620:: 593:. 571:: 544:. 520:: 493:. 479:: 452:. 427:. 415:: 392:. 333:) 327:( 322:) 318:( 314:. 300:. 152:] 120:) 114:( 109:) 105:( 95:· 88:· 81:· 74:· 47:. 20:)

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Thermoplasty

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asthma
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radiofrequency
catheter
bronchoscope
radio frequency
epithelium
blood vessels
mucosa
smooth muscle
regeneration
connective tissue

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