J. Randall Hansbrough, M.D., Ph.D. Discusses Bronchial Thermoplasty Procedure

By Adem Lewis / in , , , , , , /

– My name is James Randall Hansborough, I’m a pulmonary physician
at Graves Gilbert Clinic. I’ve been here since 1993. I do pulmonary sleep medicine
and inpatient medicine as part of the Graves Gilbert Clinic team. Bronchial thermoplasty is a technology that’s recently become available in south central Kentucky area. It’s a treatment for very severe asthma especially with bronchospasm
and severe onset of attacks of asthma. It’s a procedure that reduces the narrowing of the airway that is behind severe asthma attacks. A patient goes through first an evaluation by myself or somebody in my office to see if they’re an
appropriate candidate for it. And then the bronchial thermoplasty is a procedure that’s
done as an outpatient, takes about 45 minutes. Once we clear them for that,
get insurance clearance, they come to the
hospital, have a procedure where we go into the lung airways and we treat with a little catheter that causes a reduction in the amount of smooth muscle around the airways. The airways themselves
narrow in an asthma attack because the smooth muscle contracts and narrows the airway to a point where you can’t breath
through a very small tube. This is a treatment for
adults 18 years or older. By doing this procedure you reduce enough of the smooth muscle that that narrowing does not occur and the
patients do not have sudden attacks and in
general have much better control of their asthma. In studies that have been
done it’s been dramatic for people as far as hospitalizations, ER visits, and general quality of life. Okay as we’ve talked
about, asthma involves problems with the airways that carry air in and out of the lungs. They can suddenly become
narrow and constricted so that you can’t get air
in and out of your lungs. This tape shows us how
bronchial thermoplasty works. What you see is two airways,
the airway on the left has been treated with
bronchial thermoplasty, airway on the right has been untreated. Now we’re gonna irrigate this airway with a solution that causes an asthma attack. And as you can see the airway on the left does not constrict and has normal size compared to when we started. But the airway on the
right has narrowed down to just a very small airway, it would be extremely hard to get air in and out. This is how bronchial thermoplasty works. It keeps the airways from constricting when an asthmatic is exposed to something or is having an asthma attack. I had a 25-year-old girl who had terrible sudden onset asthma that ended her up from being mildly ill one day at work to being in
the intensive care unit on life support an hour later. We got her approved for
bronchial thermoplasty and as of date in the six months she’s had bronchial thermoplasty
she hasn’t been sick, she hasn’t even had to
use her rescue inhaler, which is something that she can’t remember not doing since she was six years old. I’m the only person in
this area that’s doing it at this time, you would
have to go either to Louisville, Lexington,
or there are a few places in Nashville that are doing it currently. But I’m the only physician
in this immediate area that’s carrying out this procedure.

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