What Is Bronchial Thermoplasty?

C.B. Fox

Bronchial thermoplasty is an outpatient procedure used to help decrease the symptoms of asthma in some patients. Though this procedure is considered to be safe and not particularly invasive, it is only performed on asthma patients who continue to have severe symptoms despite the use of medication. During the procedure, a bronchoscope is inserted into the patient's lungs and portions of the bronchial tubes are heated. The heat is able to reduce the amount of tissue in the bronchial tubes, making it easier for the patient to breathe.

Patients who undergo bronchial thermoplasty may still need to use long-acting medications delivered through a nebulizer or inhaler to prevent future attacks.
Patients who undergo bronchial thermoplasty may still need to use long-acting medications delivered through a nebulizer or inhaler to prevent future attacks.

A relatively new procedure, bronchial thermoplasty has only been in use since 2010. It is intended for patients with severe asthma, who may have life-threatening attacks that asthma medications are unable to stop. This procedure does not prevent all asthma attacks, but most patients who undergo bronchial thermoplasty see a significant reduction in the number of both minor and serious attacks.

The respiratory system.
The respiratory system.

Patients who elect to have a bronchial thermoplasty performed will be sedated and locally anesthetized during the procedure. In most cases, sedation is mild and patients may be conscious or semi-conscious while undergoing the procedure. The use of mild sedation and local anesthesia makes it possible for the patient to return home shortly after the procedure is complete.

While it won't prevent all asthma attacks, bronchial thermoplasty may prevent most major and minor ones.
While it won't prevent all asthma attacks, bronchial thermoplasty may prevent most major and minor ones.

In most cases, bronchial thermoplasty is performed three times before treatment is complete. Doctors will perform the procedure on the lower section of one lung, the lower section of the other lung and then the upper sections of both lungs. Each of these thermoplasty procedures is performed about three weeks apart to give a patient time to rest and recuperate.

Bronchial thermoplasty may help reduce serious asthma attacks.
Bronchial thermoplasty may help reduce serious asthma attacks.

To perform a bronchial thermoplasty, the doctor inserts a bronchoscope into the patient's bronchial tubes. This tool allows the doctor to see the inside of the airways and to make use of a specialized catheter that is fed into the lungs through the bronchoscope. The catheter gives off radio frequency energy, which heats the tissue on the walls of the bronchial tubes. The tissue is heated enough that some of it dies, making the bronchial tube bigger around and less able to constrict and cause an asthma attack.

Bronchial thermoplasty can help reduce the chances of requiring emergency medical care for a severe asthma attack.
Bronchial thermoplasty can help reduce the chances of requiring emergency medical care for a severe asthma attack.

Many patients who undergo the procedure see an improvement in their asthma symptoms. Overall, patients see a 32 percent reduction in asthma attacks and an 84 percent reduction in the need for emergency medical care to treat an asthma attack. Patients who have undergone bronchial thermoplasty may still need to use medication to help manage asthma symptoms, though the risk of severe attack is decreased in most patients.

Most patients who undergo bronchial thermoplasty avoid anesthesia thanks to conscious sedation medications.
Most patients who undergo bronchial thermoplasty avoid anesthesia thanks to conscious sedation medications.

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