A tiny ‘egg whisk’ inserted into the lungs is proving remarkably successful in treating severe asthma. The device, which is less than 3mm in diameter, emits radiowaves that heat the airways. This shrinks scarred, thickened lung tissue, aiding breathing.
Bronchial thermoplasty (BT) is used in cases of persistent asthma that can’t be controlled with normal medication. Some 300,000 Britons suffer the condition this severely. Patients need only moderate sedation to undergo the procedure, which means they can go home the same day.
After the treatment, asthma sufferers reported a 32 per cent reduction in attacks, and there was an 84 per cent reduction in accident and emergency visits.
Asthma, a chronic condition of the airways that can cause coughing, wheezing and breathlessness, affects more than three million Britons. It’s estimated that one in 12 adults and one in 11 children are currently being treated for the condition.
Symptoms are caused by inflammation of the small airways which carry air in and out of the lungs. They become inflamed when the sufferer comes into contact with a trigger, which can range from dust mites and tobacco smoke, to exercise and chest infections.
When this happens the muscles around the walls of the airways tighten, making them narrower. The lining of the airways becomes inflamed and starts to swell, and sticky mucus or phlegm can build up, which can further narrow them. The overall effect is that it becomes more difficult to breathe.
It’s not known what causes asthma, although it is more likely if there is a family history of the disease or eczema and allergies.
Drugs are usually given via inhalers and work by relaxing the muscles around the airways. However, with severe asthma, the smooth muscle that lines the lung thickens in response to constant irritation.
‘Although current medications are reasonably successful in controlling symptoms in the majority of cases, some patients with severe persistent asthma continue to suffer from breathing problems,’ says Dr Pallav Shah, consultant physician in respiratory medicine at Chelsea and Westminster Hospital, London.
In the past, patients with difficult-to-control symptoms were prescribed short courses of powerful steroid medication.
However, when taken for more than two weeks at a time, the risk of side effects – bloating and weight gain, depression, bone thinning and digestive problems – increases.
BT has so far been given to 50 patients in the UK, at five hospitals. During the procedure, a bronchoscope (a specially made tube with a camera) with a collapsed metal electrode on its tip is fed through the mouth or nose of the patient and moved along the throat and down into the lungs.
Once positioned, the electrode is expanded, pushing against the walls of the airways. The device is then switched on, so it emits a low-level heat which shrinks the surrounding tissues.
Each burst of heat lasts for ten seconds, after which the catheter is repositioned in another area of the lung.
The treatment consists of three separate sessions, performed three weeks apart. The first treats the airways of the right lower lobe of the lung, the second treats the left lower lobe and the third and final session treats the airways in both upper lobes. After each treatment, it is normal for patients to experience a worsening of symptoms for two to three days.
University lecturer Barry O’Shea, 56, found the treatment life changing. ‘I was just four when I developed asthma and have suffered severe attacks throughout my life,’ he says. ‘Almost anything would set it off – just smelling heavy perfume could leave me gasping for breath. That made travelling on public transport difficult. Pollen and bad weather were also triggers.
‘I was using two inhalers, long and short term, and while they worked up to a point my asthma continued to worsen over time. I was often on steroid tablets, and they made me feel awful.’
Dr O’Shea underwent the BT procedure as part of a trial two years ago. ‘After the third session my breathing was improving,’ he recalls.
‘Since the treatment I have had no major chest infections, not missed a day off work because of asthma, and had no significant wheezing. My GP tells me my asthma has gone from being severe to mild.’