Allergy, Immunology and Pulmonology

Bronchial Thermoplasty for Asthma

Bronchial thermoplasty is a therapy that offers hope to people suffering from severe persistent asthma. Most people with asthma can keep the disease in check with regular medicine, inhalers, and diet and lifestyle modifications. But for those with a severe affliction, who must make frequent hospital visits and take powerful anti-asthma drugs, bronchial thermoplasty may help.

How the Procedure Works

Bronchial thermoplasty is the first FDA-approved, non-pharmacological procedure for the treatment of severe asthma symptoms. It works by reducing the amount of smooth muscle tissue in the lungs – tissue that constricts the airway during an asthma attack, causing difficulty breathing.

In this procedure, a doctor inserts a thin plastic bronchoscope into the patient's airway, then delivers several measured bursts of radiofrequency energy, which heats the lining of the lungs. The 149 degrees F heat permanently shrinks the smooth muscle.

The procedure does not alleviate symptoms instantly, and some patients have a transient flare-up in their symptoms immediately after being treated. For safety reasons, treatment is performed in three separate visits, about three weeks apart, so such flare-ups can abate before treatment resumes. The two lower lobes are treated individually first, followed by a combined treatment of the upper two lobes.

Results

Studies have found that people who were treated with bronchial thermoplasty experienced a meaningful reduction in asthma attacks and a significant reduction in asthma-related emergency room visits and hospitalizations. More studies are underway, but the effects of the procedure so far appear to be permanent, with no follow-up treatment necessary.

Medications

Bronchial thermoplasty patients still need to continue taking certain medications, as the procedure is just one component of treatment. The procedure is not currently approved for use in children.