AHN Physicians Perform Innovative Procedure to Treat Severe, Uncontrolled Asthma

Bronchial Thermoplasty Helps Moon Township Woman Breathe Easier after Long Struggle with Debilitating Asthma

PITTSBURGH, Pa. — Doctors at Allegheny General Hospital (AGH), a part of Allegheny Health Network, are the only health­care providers in Pittsburgh offering an inno­v­a­tive, alter­na­tive tech­nique to treat severe asthma that cannot be well controlled with medi­cines.

Jennifer McBride, a 38 – year-​old resi­dent of Moon Township, was among the first patients in Pittsburgh to recently undergo bronchial ther­mo­plasty (BT) at AGH. During the proce­dure, excess smooth muscle is removed from the airways of the lung to reduce severe asthma attacks. The new therapy is being performed by AGH pulmo­nolo­gists Marvin Balaan, MD and Antonios Zikos, MD, who work in consul­ta­tion with Deborah Gentile, MD, Director of Allergy and Asthma Clinical Research in AHN’s Division of Pulmonary, Allergy and Critical Care Medicine.

Doctors at AHN’s Saint Vincent Hospital in Erie also perform the new proce­dure.

It is very exciting to have a viable non-​drug treat­ment for asthma, because medica­tion alone does not work for every patient,” said Dr. Balaan, System Division Director of Pulmonary and Critical Care at AHN.

Boston Scientific’s Alair™ bronchial ther­mo­plasty (BT) system is the first non-​medical treat­ment approved by the Food and Drug Administration (FDA) for treating severe asthma in adults when inhaled corti­cos­teroids and long-​acting beta-​agonists such as Advair, Symbicort and Dulera do not provide good asthma manage­ment. BT does not replace main­te­nance medica­tions, but works with the patient’s medica­tion to provide long-​term stability in symp­toms and lessen severe attacks.

Asthma is a chronic disease with a high burden of recur­ring medical costs and a nega­tive impact on quality of life,” said Dr. Gentile. Bronchial ther­mo­plasty could reduce the impact of life­long medical manage­ment of asthma for many patients who don’t achieve good results with medica­tions alone.”

During an asthma attack, smooth muscle in the airways constricts, making it more diffi­cult to breathe. BT uses mild heat to reduce the amount of smooth muscle in the airways and mini­mize their narrowing during asthma attacks.

No inci­sions are required for the proce­dure. The BT device is intro­duced into the lungs with a bron­cho­scope inserted through the nose or mouth,” said Dr. Zikos. “BT is performed under moderate seda­tion or general anes­thesia in three sepa­rate treat­ments sched­uled three weeks apart. Each session lasts approx­i­mately 30 minutes and focuses on a different area of the lungs until all areas are treated.”

McBride’s asthma had become so severe that she esti­mates she visited the emer­gency depart­ment or was admitted to the hospital 40 to 50 times over the last four years,” she said. It got to the point where everyday things became hard for me. And there was no simple cold; it would turn into bron­chitis or pneu­monia. With a husband and two teenage daugh­ters, I just couldn’t handle that anymore.

Since I finished the BT proce­dures, though, I can do things I couldn’t do before. I don’t use my rescue inhaler as much – before, I’d use it just to get up the stairs,” McBride added. I can get through the day without having to stop and catch my breath at work. And I just got over a common cold that, for the first time in years, didn’t turn into some­thing worse.”

BT is a valu­able tool in our arsenal to help patients with severe asthma find relief and regain their quality of life,” said Dr. Zikos. With docu­mented poor air quality and an unusu­ally high asthma rate in our region, BT could play an instru­mental role in treating Pittsburgh’s asthma epidemic.”

According to the American Lung Association’s annual State of the Air” report, the Pittsburgh metro area ranked as the 14th-​most polluted area in the country for daily fine particle emis­sions and the eighth worst for annual particle pollu­tion. Particulate matter pollu­tion is tied to multiple illnesses, including asthma.

The Asthma and Allergy Foundation of America (AAFA) also ranks Pittsburgh as the 27th-​most chal­lenging U.S. city in which to live with asthma, based on factors such as high level of expo­sure to known asthma trig­gers such as poor outdoor air quality, indoor allergen expo­sure, tobacco smoke expo­sure and high poverty rates.

Nearly 25 million Americans live with asthma. According to the AAFA, asthma contributes to more than 14 million doctor visits, 2 million emer­gency room visits, almost 500,000 hospi­tal­iza­tions and nearly 4,000 deaths each year. The annual cost of asthma is about $56 billion, including more than $50 billion in direct costs, such as hospital stays, and nearly $6 billion in indi­rect costs, such as lost wages from illness or death.

The VITAL Innovation Platform of Highmark Health helped to bring BT to AHN as part of its commit­ment to supporting the study and avail­ability of novel tech­nolo­gies and ther­a­pies in the commu­nity that may offer better solu­tions for chronic diseases.

Launched in 2015, the VITAL plat­form was designed to provide the missing link between FDA approval of a new tech­nology and its full reim­burse­ment by commer­cial insurers. VITAL is currently supporting the study of several addi­tional leading-​edge medical break­throughs at AHN hospi­tals, including: the LINX® Reflux Management System for treating patients with gastro-​esophageal reflux disease (GERD); the Avinger Ocelot™ lumi­vas­cular and Pantheris™ atherec­tomy systems to treat periph­eral artery disease; the HeartFlow non-​invasive diag­nostic tech­nology that offers physi­cians insight into both the extent of a patient’s coro­nary arte­rial blockage and the impact the blockage has on blood flow; and the Freespira Breathing System for patients who suffer from panic disorder.