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More than 24 million Americans live with asthma, a respiratory disease that causes the airways in the lungs to constrict and makes it difficult to breathe. For people with asthma, this condition can significantly impact their quality of life and in some cases can be life threatening.
The lungs consist of multiple airway passages surrounded by smooth muscle. Due to chronic inflammation and spasm, the smooth muscle in the airway passages of asthma sufferers can be thicker than in people without asthma. The resulting narrowing of the airways increases resistance to normal airflow in the lungs and leads to the well-known symptoms of wheezing, coughing and shortness of breath.
Although there is no permanent cure for asthma, it can typically be managed with medications, including:
- Long-term asthma control medications (e.g., inhaled corticosteroids, leukotriene modifiers, long-acting beta agonists and combination inhalers).
- Quick-relief (rescue) medications (e.g., short-acting beta agonists, Ipratropium [Atrovent], and oral and intravenous corticosteroids).
If asthma is triggered by allergies, allergy medications or shots may help prevent asthma flare-ups.
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A New Treatment for Severe Asthma
For people who have severe, persistent asthma, the condition can be particularly debilitating. Their asthma may not be well controlled even though they are taking the highest doses of asthma medications available.
Bronchial Thermoplasty (BT) is a new FDA-approved treatment for people 18 and older with severe asthma that is not controlled by medications. The non-drug procedure uses radiofrequency energy to reduce the thickness of the smooth muscle in the airway and limit its ability to contract and narrow the airway.
BT is a minimally invasive bronchoscopic procedure, which complements the use of asthma medications to provide long-lasting asthma control.
The treatment is not a cure for asthma, but patients usually find they can take their asthma medications less frequently. Most importantly, BT has been shown to reduce the severity of asthma attacks, visits to the emergency room, and time lost from work, school and other daily activities.
The technology used is called the Alair System, which is manufactured by Boston Scientific.
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How the Procedure Works
During the procedure, which is normally done in an outpatient setting under moderate sedation, a bronchoscope (a thin, flexible tube with a camera at the end) is introduced into the patient’s lungs through the nose. A catheter is then inserted through the bronchoscope, where it delivers radiofrequency energy to the airway walls, reducing the narrowing of the airways caused by smooth muscle.
Bronchial thermoplasty is administered in three separate treatments, scheduled approximately three weeks apart. Each treatment lasts from 30-60 minutes.
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Long-Term Effectiveness: 5-Year Data
Following are statistics about the effectiveness of bronchial thermoplasty (BT) from trials conducted by Boston Scientific.
There was an average 44% decrease over 5 years in the number of patients having severe exacerbations, compared with 1 year prior to BT treatment, which included a substantial reduction in the use of systemic corticosteroids.
There was an 84% reduction in emergency room visits for respiratory symptoms at 1 year, compared to a control group. At 5 years, there was still a 78% average decrease in the number of patients experiencing ER visits for respiratory symptoms, compared with 1 year prior to BT treatment.
More data is available at the Boston Scientific website.
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The doctors who are trained and experienced in performing bronchial thermoplasty are:
Laurence Miller, MD (914-231-7666)
Alex Fijman, MD (914-762-4141)
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