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bronchial thermoplasty

Indications: - severe asthma Procedure: - radiofrequency ablation of proximal airway smooth muscle - a series of 3 procedures [2] Clinical significance: - improves asthma control that persists for at least a 10 years in patients with moderate or severe asthma [4] - for patients with initial asthma exacerbation rates of 50%/year, asthma exacertation rates are 24% at year 1, 22% at year 2, & 25% at year 10 with bronchial thermoplasty vs 37% at year 10 for sham control [4] Complications: - hospitalizations more common (6%) during the initial 6 week treatment period [2] - 7% 10 year incidence of new bronchiectasis (clinically insignficant) vs none in sham control [4]

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asthma

General

bronchoscopic procedure

References

  1. Cox G et al Asthma Control during the Year after Bronchial Thermoplasty N Engl J Med 2007, 356:1327-1337 http://content.nejm.org/cgi/content/short/356/13/1327
  2. Wechsler ME et al. Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. J Allergy Clin Immunol 2013 Aug 30 PMID: 23998657
  3. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
  4. Chaudhuri R et al. Safety and effectiveness of bronchial thermoplasty after 10 years in patients with persistent asthma (BT10+): A follow-up of three randomised controlled trials. Lancet Respir Med 2021 May; 9:457. PMID: 33524320 https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30408-2/fulltext