Only one hospital in Texas offers bronchial thermoplasty for patients with asthma. The system to provide this procedure was approved by the United States Food and Drug Administration in April of 2010 to reduce the number of severe asthma attacks in patients with severe, persistent asthma. Nicole Acosta was the first person to receive the new treatment at St. David's Georgetown Hospital, about 30 miles north of Austin, Texas. It changed her life, according to a story in the Austin American-Statesman.
A characteristic feature of asthma is increased mass of the airway smooth muscles. Bronchial thermoplasty is a procedure to reduce this mass by delivering controlled radiofrequency heating to the lungs. I found 41 reports about this procedure in the medical literature, starting in 2004.
An article in the New England Journal of Medicine reports that bronchial thermoplasty produced an improvement in control of moderate to severe asthma over a one-year study period. Compared to the control group, the thermoplasty group had better morning peak expiratory flow, scores on the
Asthma Quality of Life Questionnaire, percentage of symptom-free days, and symptom scores, with less use of rescue medication.
However, patients can expect to feel worse before they feel better after bronchial thermoplasty. Reference 3 reports 407 adverse events in the treatment group, compared to 106 adverse events in the control group. The majority occurred within the first day after the procedure, and cleared up within seven days. The FDA lists side effects of the treatment as:
1. Asthma attacks
2. Wheezing
3. Chest discomfort or pain
4. Partial collapse of the lungs
5. Lower airway bleeding
6. Anxiety
7. Headache
8. Nausea
The procedure is not for patients with these characteristics:
1. Implanted electronic devices such as pacemaker or defibrillator
2. Sensitivity to medications used for bronchoscopy procedures, including lidocaine, atropine, and benzodiazepines
3. Active respiratory infection
4. Severe asthma attacks or change in corticosteroid medication in the last 14 days
5. Problems with blood coagulation
Treatment generally requires three procedures for different areas of the lungs, and should not be repeated on the same area.
The equipment manufacturer provides more details online at http://www.btforasthma.com/. To locate a provider, you can fill out the information request form.
References:
1. Austin American-Statesman, December 22, 2010, p. B1.
2. FDA approval information:
http://www.fda.gov/medicaldevices/productsandmedicalprocedures/deviceapprovalsandclearances/recently-approveddevices/ucm212594.htm
3. Cox G et al, “Asthma control during the year after bronchial thermoplasty”, New England Journal of Medicine 2007; 356: 1317-37.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.