bronchial thermoplasty
DESCRIPTION
Short presentation on Bronchial Thermoplasty for community presentation ( NOT for health care professionals) Edward Omron MD, MPH, FCCP Pulmonary Medicine Morgan Hill, CA 95037 www.docomron.comTRANSCRIPT
Bronchial Thermoplasty
Edward Omron MD, MPH, FCCPPulmonary and Critical Care MedicineSaint Louise Regional Medical Center
What is Asthma?
• Reversible lung disease• The airways of the lung are inflamed, swollen and
narrowed resulting in “wheezing”• Breathing problems occur in “attacks” but the
disease is continuous • Recurrent cough, chest tightness / pain, or shortness
of breath• Symptoms worsen with exercise, infection, changes
in weather, or at night.
Asthma Airways
Asthma Facts
• In 2009, 25 million Americans had asthma– Of these 13 million have had an asthma attack
• In 2007 there were 3500 deaths from asthma– 63% of these deaths occurred in women
• The prevalence of adult asthma in CA 2009 is 8%• Asthma accounts for 50 billion health care dollars
yearly
Types of Asthma
Mainstays of Therapy
Inhaled Corticosteroids Remain the MAINSTAY of treatment in all asthmatic groups
Current Therapies
• Remove asthma triggers• Short acting bronchodilators• Inhaled Corticosteroids• Long Acting Bronchodilators• Leukotriene Modifiers• Steroids• Anti IgE Modifiers• EXERCISE
Advances in Therapy
• There is no cure of asthma thus far in 2012• CONFIRM the diagnosis before any
augmentation of treatment of regimens– Rule out for example vocal cord dysfunction– Interstitial Lung Disease
• Severe persistent asthma is a great challenge to both the patient and the physician
Bronchial Thermoplasty (BT)
• Severe asthmatics have excessive smooth muscle in the airways
• BT is a non-drug procedure that reduces airway smooth muscle by applying heat to the airways– This reduces the frequency of asthma attacks
• Three outpatient procedures performed three weeks apart under sedation
• Benefits:– 32% reduction in asthma attacks– 84% reduction in ER visits– Improved asthma quality of life
Bronchial Thermoplasty
Short Term Side Effects• Mild and related to airway irritation– Coughing– Dyspnea– Wheezing
• Mean Time to onset: 1.7 days• Mean Time to resolution: 4.6 days• Only 42% of side effects required use of
medications: antibiotics, inhalers
AIR 2 Results Efficacy (288 patients)
• Severe exacerbations: 32% reduction• Emergency Department Visits: 84% reduction• Days missed from work or school: 1.3 vs 3.9 days• AQLS: BT 1.35 vs 1.16
• AJRCCM 2010: 181; 116-124
Long Term Side Effects
• Chest CT at 1 and 2 years post treatment
– No Evidence of Bronchiectasis– No Evidence of Bronchial Wall Disease– No Evidence of Lung Parenchyma Changes
Resources
• American Lung Association– http://www.lung.org/lung-disease/
• http://www.onebreath.org/• http://www.thoracic.org/education/breathing
-in-america/index.php