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Bronchial Thermoplasty

Led by Dr. Jonathan Pulchalski, a patient undergoes bronchial thermoplasty for the treatment of persistent asthma in the bronchoscopy suite in the Yale New Haven Hospital. This innovative procedure is only one of the many available treatment options that asthma sufferers may be advised to pursue at the YCAAD.
About Bronchial Thermoplasty
Bronchial thermoplasty is an innovative, new, non-drug procedure developed for the treatment of severe persistent asthma. Bronchial thermoplasty delivered by the Alair® System uses thermal energy to reduce the muscle associated with airway constriction in asthma patients. Clinical studies of this treatment have demonstrated sustained improvements in asthma control up to a year following the treatment. Treated patients not only enjoyed improved asthma-related quality of life for the year following treatment but also fewer severe asthma attacks, fewer visits to the emergency room for respiratory symptoms, and fewer days lost from work/school or other daily activities due to asthma symptoms.

Overview of Bronchial Thermoplasty Procedure
Bronchial thermoplasty delivered by the Alair® System is performed under direct visualization through the working channel of a standard flexible bronchoscope that is introduced through a patient’s nose or mouth and into their lungs. The tip of the small diameter Alair® catheter is expanded to contact the walls of targeted airways reachable by the bronchoscope. Controlled thermal energy then is delivered to the airway walls to reduce the presence of airway smooth muscle that narrows the airways in patients with asthma.

Bronchial thermoplasty is performed in a bronchoscopy/ endoscopy suite and takes about an hour to complete. The minimally invasive procedure, like many other flexible endoscopy procedures, is done under moderate sedation. No
incision is necessary. Post-procedure, patients typically are observed and monitored for approximately 2-4 hours.

There is an expected transient increase in the frequency and worsening of respiratory-related symptoms immediately following bronchial thermoplasty. These events typically occur within one day of the procedure and resolve within seven days, on average, with standard care. An overnight hospital stay may be appropriate in the event of worsening asthma symptoms after the procedure.

Animation of Bronchial Thermoplasty (BT) with the Alair® System

The Alair® Bronchial Thermoplasty (BT) System is the first device-based asthma treatment approved by the FDA and has been shown to help adults with severe asthma gain better control of their disease.

BT uses a small, flexible tube (a bronchoscope), that is inserted through the mouth or nose and guided into the lungs. When the bronchoscope reaches the desired airway, a catheter applies controlled energy to the airway wall to reduce the amount of excess airway smooth muscle. A reduction of airway smooth muscle decreases the ability of the airways to constrict, thereby reducing the frequency of asthma attacks and improving patients quality of life.

A typical BT treatment session lasts less than an hour to complete and a total of three treatment sessions is required to treat the entire lung.