Can the Number of Radiofrequency Activations Predict Serious Adverse Events after Bronchial Thermoplasty? A Retrospective Case-Control Study.

Published on Nov 7, 2019
· DOI :10.1007/S41030-019-00103-7
Shota Yamamoto4
Estimated H-index: 4
(Tokai University),
Motoyasu Iikura21
Estimated H-index: 21
+ 14 AuthorsHaruhito Sugiyama19
Estimated H-index: 19
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Abstract
Introduction Bronchial thermoplasty (BT) is a bronchoscopic procedure that involves the delivery of thermal radiofrequency energy to the bronchial wall for treating severe asthma. It has been suggested that too many radiofrequency activations could induce serious adverse events (SAEs) at an early stage. We aimed to examine the number of radiofrequency activations at each session and early lung function changes from baseline to determine whether these are related to SAEs.
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Background Bronchial thermoplasty (BT) is an endoscopic procedure for the treatment of severe refractory asthma, based on the local airways delivery of radio-frequency at 65 °C. Several controlled clinical studies demonstrated the effectiveness of BT on clinical outcomes, particularly the reduction of asthma exacerbations. During procedure or shortly after, significant but transient respiratory adverse events have been reported.
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#1David Langton (Monash University)H-Index: 12
#2Wei Wang (Monash University)H-Index: 22
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Abstract Background The most common adverse effect of bronchial thermoplasty (BT) is short-term aggravation of asthma immediately following the procedure. However, the magnitude and duration of this deterioration, and its predisposing factors are yet to be quantitated. This information will be particularly important as BT is extended to include more severely obstructed patients. Methods In this prospective, observational study of 20 consecutive patients with very severe asthma undergoing BT, pos...
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#1Akifumi FunatsuH-Index: 1
#2Konomi Kobayashi (Teikyo University)H-Index: 1
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Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma using thermal energy to reduce smooth muscle in the bronchial wall. A 47-year-old man underwent BT for uncontrolled severe asthma despite maximal pharmacological treatment. After a third procedure, he experienced hypoxaemia because of complete bilateral upper lobe atelectasis. A pulmonary cyst suddenly emerged in to the right middle lobe, associated with the pneumothorax on postoperative day 6, and a chest drainage tube w...
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#1Annika W.M. Goorsenberg (UvA: University of Amsterdam)H-Index: 6
#2Julia N S d'Hooghe (UvA: University of Amsterdam)H-Index: 7
Last. Peter I. Bonta (UvA: University of Amsterdam)H-Index: 22
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Background: Bronchial thermoplasty (BT) is an endoscopic treatment for severe asthma targeting airway smooth muscle (ASM) with radiofrequent energy. Although implemented worldwide, the effect of BT treatment on the airways is unclear. Optical coherence tomography (OCT) is a novel imaging technique, based on near-infrared light, that generates high-resolution cross-sectional airway wall images. Objective: To assess the safety and feasibility of OCT in severe asthma patients and determine acute ai...
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#1Igor L. Chernyavsky (University of Manchester)H-Index: 10
#2Richard J. Russell (University of Leicester)H-Index: 8
Last. Christopher E. Brightling (University of Leicester)H-Index: 110
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Bronchial thermoplasty is a treatment for asthma. Whether during thermoplasty the airway wall fraction exposed to temperatures necessary to affect cells is sufficient to explain its histopathological impact is unclear. Airway smooth muscle and bronchial epithelial cells were exposed to media (37–70°C) for 10 seconds to mimic thermoplasty. In silico we developed a mathematical model of airway heat distribution following thermoplasty. In vivo we determined airway smooth muscle mass and epithelial ...
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#1Julia N S d'Hooghe (UvA: University of Amsterdam)H-Index: 7
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Background: Bronchial thermoplasty (BT) is a novel treatment for severe asthma based on radiofrequency energy delivery to the larger airways. Although impressive radiological abnormalities have been reported, the incidence, pattern, and behavior over time of acute radiological abnormalities following BT are not well established. Objective: To assess the incidence pattern and behavior over time of acute radiological abnormalities following BT. Methods: This is a prospective, observational imaging...
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#1David Langton (Monash University)H-Index: 12
#2Joy Sha (Frankston Hospital)H-Index: 5
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Background Bronchial thermoplasty (BT) is an emerging bronchoscopic intervention for the treatment of severe asthma. The predictive factors for clinical response to BT are unknown. We examined the relationship between the number of radiofrequency activations applied and the treatment response observed.
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Bronchial thermoplasty (BT) is a recent, promising and well-tolerated technique for the treatment of severe asthma. By delivering thermal energy to the airway wall, this procedure can induce early pulmonary opacities seen on computed tomography (CT). We aimed to examine early CT modifications induced by BT and to determine their association with respiratory symptoms. Unenhanced chest CT was performed the day after each BT session in 13 patients with severe asthma, leading to the examination of 3...
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Fungal infections are rarely reported as a complication of bronchial thermoplasty (BT) in patients without immunosuppressive comorbidity. A 19-year-old woman college student was admitted to our hospital owing to uncontrolled severe asthma despite using the maximum dose of steroid inhalation. She experienced asthmatic attacks more frequently while cheerleading, which is an extracurricular activity. She received BT because she wanted to continue cheerleading. After the second BT session, she devel...
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#1Ying Nong (China-Japan Friendship Hospital)
#2Jiangtao Lin (China-Japan Friendship Hospital)H-Index: 12
Bronchial thermoplasty (BT) is a novel bronchoscopic intervention for severe persistent asthma. An increase in transient respiratory adverse events associated with BT were noted over the treatment periods, however, these events appear sporadic and should not always recur in a single individual and BT-related pneumonia has rarely been reported. We present a case of uncontrolled severe asthma who developed puzzling pneumonia sequentially after each session of BT procedures. After each operation of...
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