Bronchial Thermoplasty for Severe Asthma: Breathe Easier at National Jewish Health

National Jewish Health is one of the first institutions in the United States to offer a procedure for people with severe asthma to help them breathe more easily This procedure is known as bronchial thermoplasty (BT).

BT is an FDA-approved procedure for the treatment of asthma; it was approved in 2010 for use in people 18 years or older with severe asthma whose symptoms are not well controlled with inhaled corticosteroids and long-acting beta agonists.

^{Video courtesy of Boston Scientific Corporation}

Transcript

With normal breathing, the airways of the lungs are fully open, as in this cross section of an airway.

People with severe asthma have more airway smooth muscles circling their airways.

This excess muscle, together with inflammation of the airways, combines to make the airway walls thicker than normal.

During an asthmatic attack, in response to an asthma trigger, such as an allergen or irritant,

the airway smooth muscle contracts, leading to airway narrowing and breathing difficulties.

During bronchial thermoplasty, a small flexible tube is advanced into the airway through a standard flexible bronchoscope,

placed through the mouth or nose. No incision is required.

The Allaire device has an expandable wire electrode array at the tip,

and when it is expanded, the four arms of the electrode array come in contact with and fit snugly against the airway wall.

The expanded electrode array will then deliver controlled radio frequency energy for about 10 seconds to heat the airway smooth muscle.

About one-third of the targeted lung areas are treated during a single procedure.

A total of three procedures are currently needed for complete treatment.

Once the procedure is completed, the device and the bronchoscope are removed.

The controlled energy delivered during bronchial thermoplasty creates mild heat within the airway wall that is designed to reduce the amount of airway smooth muscle.

By reducing the amount of airway smooth muscle, the procedure reduces the ability of the airway walls to contract and narrow during an asthma attack.

Benefits of Bronchial Thermoplasty

In clinical trials, BT has been shown to improve asthma-related quality of life in 79% of people who received treatment.

People treated with BT also had:

84% fewer asthma-related emergency room visits
66% fewer days lost from work, school, and other activities due to asthma symptoms
32% fewer severe asthma attacks.

How Bronchial Thermoplasty Works

BT helps to reduce the smooth muscle mass in the airways through delivery of controlled thermal (heat) energy to the airway walls. The thermal energy is delivered to the airway walls over a series of 3 bronchoscopies.

Learn what to expect during the BT procedure.

Good Candidates for Bronchial Thermoplasty

You may be a good candidate for the BT procedure if:

you are 18 years of age or older,
you have severe asthma,
and your symptoms are not well controlled despite the use of inhaled corticosteroids and long-acting beta agonists.

Ineligible Candidates for Bronchial Thermoplasty

You are not a candidate for BT if:

You have a pacemaker, internal defibrillator, or some other type of implantable electronic device.
You have sensitivity to the medications used when performing a bronchoscopy, including benzodiazepines, atropine and lidocaine.
You have been previously treated with BT.

Side Effects of Bronchial Thermoplasty

There are few side effects from the BT procedure, but people may experience temporary worsening of respiratory symptoms within one to seven days following the procedure. There is a small risk (3.4%) of these symptoms requiring hospitalization.

National Jewish Health for Bronchial Thermoplasty

If you have severe asthma, seek the best care possible.

At National Jewish Health, you have the support of the leading respiratory hospital in the nation. People come from around the world to receive treatment they can’t find anywhere else.

Dr. Michael Wechsler performs the BT procedure at National Jewish Health. He's performed the procedure dozens of times and served as the principal investigator of the study (AIR2 Trial), which was the largest BT research trial in the world.

Dr. Wechsler lectures internationally on BT and presented five year data on BT at the American Thoracic Society meeting in 2013.

Beyond the BT procedure itself, our team of pulmonary specialists will help you take control of your asthma using a multidisciplinary approach to treat all aspects of asthma. We offer a wide range of individualized treatment programs that reflect your specific needs. As a dedicated partner in helping you manage your asthma we provide:

Diagnostic tests not available elsewhere
Rehabilitation services, including pulmonary rehab and occupational therapy
Nutrition education and counseling
Psychological assessment and treatment

Additionally, our team of insurance and administration specialists will work with you and your insurance to determine whether BT is a covered benefit under your policy.

Contact us - we can help you breathe more easily.

Make an appointment online or call us at 1.877.CALL NJH (877.225.5654)

Email us at bt@njhealth.org

Physician referrals and consults

Reasons to Choose National Jewish Health

The leading respiratory hospital in the nation and the only one devoted fully to the treatment of respiratory and related illnesses
Ranked #1 or #2 in Pulmonology by U.S. News & World Report for 26 consecutive years
Ranked in the top 5% of hospitals in the nation by HCAHPS
Physicians consistently recognized among the best in the nation by multiple services, including Best Doctors in America and Castle Connolly
Among the top 6% of organizations funded for research by the NIH, providing patients access to hundreds of active clinical trials
124-year history of focus on care, research and education serving patients from around the world with lung, heart, immune and related disorders

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