Safety of the application of bronchial thermoplasty with a modified protocol: Experience in our centre

Introduction: Bronchial thermoplasty (BT) is a new treatment for severe and uncontrolled asthma. The Alair® catheter (Boston Scientific) has in its distal extreme electrodes to apply radiofrequency. Standard protocol indicates application from distal to proximal visual bronchi, guided by 5 mm marks, and without losing visual contact of the catheter tip. We evaluate the safety of a new protocol of BT, which consists in introducing the catheter up to the last mark, 2 cm above the electrode, loosing visual control of its distal extreme. It would increase the treated bronchial area and may improve the efficacy of BT.

Methods: Procedure length, number of activations and adverse events (AE) intra (IP) and 24h post-procedure (PP) were collected. AE were classified into:

Mild: transient symptoms that not required treatment.

Moderate: symptoms that caused interference with patient's usual activities, requiring symptomatic treatment.

Severe: symptoms that require medical intervention and/or treatment.

Results: 9 patients were included (88,9%; 50±17.1years). Mean FEV1 post-bronchodilator 82±15%. During the procedure 77,8% patients had mild-moderate AE. 92,6% patients had AE in PP, being the 92% AE (23/25) mild-moderate and 8% (2/25) severe.