Early radiologic and bronchoscopic changes after bronchial thermoplasty in patients with severe asthma

Qiu,Minzhi; Wei,Shushan; Lai,Zhengdao; Huang,Peikai; Wang,Zhiqiang; Zhong,Changhao; Chen,Yu; Zhang,Xiaoxian; Lin,Xiaofeng; Zeng,Qingsi; Chung,Kian Fan; Zhang,Qingling; Xie,Jiaxing; Li,Shiyue

doi:10.3892/etm.2020.9408

December-2020 Volume 20 Issue 6

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December-2020 Volume 20 Issue 6

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Article Open Access

Early radiologic and bronchoscopic changes after bronchial thermoplasty in patients with severe asthma

Authors:
- Minzhi Qiu
- Shushan Wei
- Zhengdao Lai
- Peikai Huang
- Zhiqiang Wang
- Changhao Zhong
- Yu Chen
- Xiaoxian Zhang
- Xiaofeng Lin
- Qingsi Zeng
- Kian Fan Chung
- Qingling Zhang
- Jiaxing Xie
- Shiyue Li
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Affiliations: Department of Respiratory and Critical Care Medicine, Shenzhen Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China, Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China, Department of Respiratory and Critical Care Medicine, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China, Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, P.R. China, Airway Disease Section, National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield NHS Foundation Trust, London SW3 6LY, UK

Copyright: © Qiu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 278
|
Published online on: October 27, 2020

https://doi.org/10.3892/etm.2020.9408
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Abstract

Bronchial thermoplasty (BT) is a treatment to reduce the airway smooth muscle mass by delivering radiofrequency thermal energy to the airways. BT is used in patients with severe asthma. The present study reported on cases of pneumothorax directly after BT and retrospectively analyzed early radiologic and bronchoscopic modifications after BT. The clinical data and radiologic and bronchoscopic findings of 12 patients with severe asthma who were subjected to BT between July 2014 and October 2017 were analyzed. A total of 33 chest radiographs were collected within 18‑24 h after BT. Radiological abnormalities were observed in 32 radiographs as atelectasis (53.1%), peribronchial consolidations (84.4%), pleural effusion (18.8%), effusion in oblique fissures (3.1%), pleural thickening (6.3%) and pneumothorax (3.1%). Of note, one patient suffered pneumothorax after the third BT session and underwent chest drain insertion, followed by mechanical ventilation at the intensive care unit and multiple bronchoscopic interventions, which revealed extensive phlegm plugs. A total of six patients with worsened symptoms and lobar atelectasis also required bronchoscopic intervention, which revealed that phlegm plugs occluded the bronchus in the treated lobe. No bronchoscopic intervention was required in the remaining five patients. During 16‑30 days of follow‑up, 95.7% of the findings on chest radiography were resolved. To the best of our knowledge, the present study reported the first case of pneumothorax following BT. Early radiologic modifications such as atelectasis and peribronchial consolidations appear common after BT. However, whether bronchoscopic intervention is required for atelectasis following BT warrants further investigation. Of note, BT should be audited and recorded in detail to ideally contribute to a framework of clinical trials to improve risk‑benefit evaluations and the selection of patients likely to benefit from treatment.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Early radiologic and bronchoscopic changes after bronchial thermoplasty in patients with severe asthma

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