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.