What is Bronchial Thermoplasty?
Most people can control their asthma with medication and lifestyle changes. But severe asthma occurs when people have difficulty controlling asthma despite taking their medicines as prescribed by their healthcare provider. Asthma causes inflammation of the airways making them smaller and making it harder to breathe. The wall of large airways has a layer of smooth muscle and this area can be thicker in people with severe asthma. During an asthma attack, this muscle layer can tighten, making the airways narrow.
Bronchial thermoplasty is a procedure that may be useful for certain people with severe asthma. It delivers energy to the inside of large airways, that results in heat which thins out the layer of smooth muscle. This can result in less tightening of the airways during asthma attacks, reducing 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). There is a total of three sessions, targeting a different area of your lungs and done, each done at least three weeks apart.
Before the procedure, you will have breathing tests to make sure your lung function is strong enough to safely proceed. Oral steroids are given before and after the procedure to help decrease any swelling that can occur.
Bronchial thermoplasty is a bronchoscopy procedure commonly performed with sedation and some form of anesthesia. A thin, flexible tube (bronchoscope) is introduced through your nose or mouth into your lungs. The thermoplasty catheter is passed through the bronchoscope and delivers energy to the inside of large airways resulting in heating and then thinning of the muscle layer. Afterward, you will be observed for at least a few hours and sometimes overnight should your asthma symptoms happen to worsen after the procedure.
Understanding the Results
Bronchial thermoplasty may reduce daily symptoms of asthma, reduce the number of sick days from work or school and help keep you out of the hospital or emergency room. Bronchial thermoplasty is not a cure for asthma, and you will still need to take asthma medications after you have completed the procedure.
What Are the Risks?
As with any procedure, there are risks, and the most common side effect of bronchial thermoplasty is a temporary worsening of breathing symptoms from irritation of the airways. Symptoms are similar to an asthma attack and can include difficulty breathing, chest tightness and wheezing which could last up to a few days. A few patients (5% – 8%) may require hospitalization if these symptoms become severe. Bronchial Thermoplasty is indicated only for adults,
Thomas Gildea, MD, MS, FCCP
Lamia Ibrahim, MD
University Hospitals Case Medical Center
Diego Maselli Caceres, MD, FCCP
UT Health Science Center at San Antonio
Ian Nathanson, MD, FCCP
Jay Peters, MD, FCCP
South Texas Veterans Health Care System
Rachel Taliercio, DO
Date Last Reviewed
1.Cox P, et al. Eur Respir J. 2004;24:659-663.
2.National hospital discharge survey, Centers for Disease Control. 2009
3.Castro M, et al, for the AIR2 Trial Study Group. Am J Respir Crit Care Med. 2010;181:116.
4.Wechsler M, et al; for the AIR2 Trial Study Group. J Asthma Clin Immunol. August 2013