Bronchial Thermoplasty

Last Updated 11/10/2020

Authors:Thomas Gildea, MD, MS, FCCP; Lamia Ibrahim, MD; Diego J Maselli, MD, FCCP; Ian Nathanson, MD, FCCP; Jay Peters, MD, FCCP; Rachel Taliercio, DO

About Bronchial Thermoplasty

Asthma causes the airways to swell and become inflamed. The airways become smaller, which makes it harder for you to breathe. The walls of large airways have a layer of smooth muscle. This area can be thicker in people with severe asthma. During an asthma attack, this muscle layer can tighten, narrowing the airways. Most people can control their asthma with medication and lifestyle changes. But people with severe asthma may have difficulty controlling their asthma even with prescribed medications.

If you have severe asthma, a procedure called bronchial thermoplasty may help. Bronchial thermoplasty delivers energy to the inside of large airways. That energy gives off heat, which thins the layer of smooth muscle, which can result in less tightening of the airways during asthma attacks. The procedure can reduce asthma symptoms and asthma attacks so that you can better control your asthma.

What to expect

Bronchial thermoplasty is performed by a lung doctor (pulmonologist) over a total of 3 sessions, each one 3 weeks apart. Each session targets a different area of your lungs.

Before the procedure, your health care provider will order breathing tests to make sure it’s safe for you to have bronchial thermoplasty. You will take oral steroids, such as prednisone, 2 days before each procedure, the day of the procedure, and 2 days after the procedure. This medication helps decrease swelling.

Bronchial thermoplasty is done while you’re under anesthesia. A thin, flexible tube (called a bronchoscope) goes up your nose or mouth and into your lungs. Then, a thermoplasty catheter is passed through the bronchoscope. The catheter delivers energy to the inside of your large airways that heats them and thins the muscle layer. Afterward, you stay in the hospital for at least a few hours. If your asthma symptoms get worse after the procedure, you may stay in the hospital overnight.

Understanding the results

Bronchial thermoplasty may:

  • Reduce daily symptoms of asthma;
  • Reduce the number of sick days you need to take from work or school;
  • Decrease the need for steroid medications; and
  • Help keep you out of the hospital or emergency department.

Bronchial thermoplasty isn’t a cure for asthma, though. You will still need to take asthma medications after you have this procedure.

What are the risks?

As with any procedure, bronchial thermoplasty has risks and side effects. The most common side effect is a temporary worsening of breathing symptoms because of irritation of your airway. Symptoms are similar to an asthma attack: They can include difficulty breathing, chest tightness, and wheezing. These symptoms can last up to a few days. Rarely, people who have had this procedure require emergency care.

Bronchial thermoplasty is safe only for adults.