Bronchial thermoplasty is delivered by the Alair® System and is performed in three outpatient procedure visits, each scheduled approximately three weeks apart. The first procedure treats the airways of the right lower lobe, the second treats the airways of the left lower lobe and the third and final procedure treats the airways in both upper lobes. After all three procedures are performed the bronchial thermoplasty treatment is complete.
Bronchial thermoplasty is performed during bronchoscopy, which is a minimally invasive procedure that is routinely performed by a physician trained in bronchoscopy, typically a pulmonologist.
Bronchoscopy is a procedure that allows the physician to examine and treat the lungs with an instrument called a bronchoscope. The bronchoscope is a long flexible tube that has a camera on one end, and allows the physician to see inside the lungs without an incision.
The procedure is performed as follows:
- You are appropriately prepped and placed under moderate sedation. Moderate sedation has also been called “twilight sleep” or “conscious sedation”. Moderate sedation is administered through an intravenous catheter (“IV”) to provide relaxation and to minimize discomfort. You will feel drowsy and may even sleep through portions of the procedure, but at all times you will be easily awakened when spoken to or touched.
- A standard flexible bronchoscope is introduced into the bronchial tree through either your nose or the mouth, and the Alair® Catheter is introduced into your airways through the bronchoscope.
- The bronchoscope is then navigated to the first target treatment site, typically the most distal airway in the targeted lobe.
- BT is delivered by the Alair® System, which is comprised of an Alair® Catheter and an Alair® Controller.
- Once the Alair® Catheter is positioned at the desired location of your airway, the electrode array at the tip of the Alair® Catheter is expanded to contact your airway wall; the physician activates the Alair® Radiofrequency (RF) Controller to deliver RF energy through the Alair® Catheter to your airway wall.
- The Alair® RF Controller delivers low-power, temperature-controlled RF energy to the airway for a maximum of 10 seconds per activation. The RF energy heats the wall of a portion of your airways in a controlled manner.
- The application of heat to the airway wall is intended to reduce the amount of excessive airway smooth muscle present in the airways and limit its ability to contract and narrow the airway.
- A single activation of the Alair® Catheter delivers RF energy over a distance of 5 mm (the length of the exposed electrodes within the electrode array). Audible and visual cues from the Alair® RF Controller signify proper delivery of RF energy.
- After each activation the Alair® Catheter is repositioned and subsequent activations are performed contiguously (adjacent but not overlapping) along your airway. This technique is used in all of your accessible airways distal to the mainstem bronchi and = 3 mm in diameter. The Alair® Catheter is deployed from the distal to the proximal end of your airway being treated. This process is repeated in all of your airways that are accessible and planned for that bronchoscopy session.
- Following the procedure, you are monitored similar to other bronchoscopy procedures. You will be discharged to home the same day if your breathing, heart rate, blood pressure, level of oxygen in the blood, and lung function tests are near normal levels.
