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Upstate offers new procedure for treating severe, persistent asthma

A new treatment option for individuals suffering from severe, persistent asthma is now available at Upstate University Hospital. It’s called bronchial thermoplasty, and doctors say it can greatly improve the life of asthma sufferers, by lessening their dependence on harsh drugs and keeping them out of the emergency room for breathing troubles.

Upstate is the only hospital in New York state outside of New York City to offer this procedure.

“This is a group of patients we have not been able to help as well as we should have,” said Robert Lenox, MD, a pulmonolgist at Upstate who is one six physicians offering the procedure.  “This new procedure will greatly enhance their quality of life.”

Here’s how it works: A long flexible tube, called a bronchoscope, is threaded through the patient’s nose or mouth into the airway. Once the bronchoscope is in position, the doctor then threads the thermoplasty device, called the Alair Catheter through the bronchoscope. Touching the tip of the catheter to the airway muscle, the doctor then applies radiofrequency waves that heat the muscle causing it to shrink, thus widening the airway passage for easier breathing.

The treatment is done in three stages, each focusing on a particular location of the airways in the lungs: the right lower lobe, the left lower lobe and airways of both upper lobes. A total treatment to shrink muscles throughout the entire airway system takes about three 90-minute sessions, which are spread out over three months.

The procedure is done with the patient under mild sedation. The patient is discharged the same day as the procedure.

Patients undergoing the procedure may experience some coughing, wheezing, sore throat and other minor side effects.

Bronchial thermoplasty may be recommended for anyone over the age of 18 who suffers from severe, persistent asthma.  Some medical conditions and implanted devices may disqualify a patient from the procedure.

An asthma attack is what happens when muscles tighten around one’s airways making breathing difficult. Additionally, the inflamed airway produces thicker mucus worsening what can already be life-threatening symptoms.

The Alair Bronchial Thermoplasty System was approved by the Food and Drug Administration for treatment of severe, persistent asthma in April 2010.  It’s the first device-based asthma treatment approved by the FDA.

In a double-blind, randomized, sham-controlled clinical study of bronchial thermoplasty, adults with severe asthma who were treated with bronchial thermoplasty had improved asthma-related quality of life out to a year compared to the control (sham-treated) patients.  Additionally, when compared to control patients, patients treated with bronchial thermoplasty also experienced the following significant benefits:

•32 percent reduction in asthma attacks
•84 percent reduction in emergency room visits for respiratory symptoms
•66 percent reduction in days lost from work, school, or other daily activities due to asthma symptoms
•73 percent reduction in hospitalizations for respiratory symptoms

It’s estimated that more than 24 million people in the United States are diagnosed with asthma and as many as 10 percent of asthma sufferers are believed to have severe, persistent asthma.  These individuals are commonly treated with high doses or cordicosteriods, with significant side effects, and routinely find themselves in the local Emergency Room because their asthma has greatly constricted their airways, making breathing difficult.

Caption: Bronchial thermoplasty features the use of a flexible tube with an expandable wire array at the tip that is introduced through the lungs by a bronchoscope. A separate radiofrequency controller supplies energy via the catheter (above) to the airway wall, shrinking the muscle to ease breathing.

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