Abstract
Background: Bronchial thermoplasty (BT) is a non-pharmacological treatment for uncontrolled severe bronchial asthma. This bronchoscopic procedure reduces the mass of airway smooth muscle and attenuates bronchoconstriction by heat energy at 65 °C. Temporary wheezes and respiratory symptoms are reported as an early complication after BT treatment, but its detailed pathomorphological phenomenon is unclear.
Objectives: The aim of this study is to elucidate the short-term adverse events after BT.
Methods: Nine uncontrolled severe asthma patients were undergone BT treatment (27 cases) in our institution since 2015. The mean age was 56.0 years old, the disease duration was 22.7 years, GINA treatment step was 5, exacerbation rate was 4.4 /year. We prospectively studied short-term adverse events after BT treatment.
Results: Average activation counts and time during BT treatment were 56.1 times (75.0 min) at right lower lobe, 51.7 times (69.9 min) at left lower lobe, 85.1 times (78.9 min) at bilateral upper lobes, respectively. Central bronchitis and peri-bronchitis were observed in all cases. Peripheral atelectasis was observed in 3 of 27 cases. Peribronchial opacity appeared several hours after BT. The density and expanse of the opacity peaked at POD 2 and vanished within POD 7. Pneumonia appeared in 3 of 27 cases. Asthma attack required intravenous steroids was observed 2 cases.
Conclusion: Reversible bronchitis and peribronchitis was observed as an inflammatory response to 65°C heat energy after BT treatment.
- Copyright ©the authors 2016
