What is bronchial thermoplasty?
Bronchial thermoplasty is a procedure used to treat severe asthma. It involves controlled delivery of therapeutic radiofrequency energy to the walls of the lung airways (bronchi). During inhalation, air travels through the nose and mouth into the trachea (wind pipe). The trachea further divides into two tubes called bronchus (bronchi). The bronchi branch out into smaller tubes called bronchioles.
Bronchial thermoplasty heats the bronchi to reduce the amount of smooth muscle present in the airway wall, reducing the capacity of the immune system to cause the kind of bronchoconstriction that leads to asthma attacks.
Bronchial thermoplasty is normally used in patients with severe, persistent asthma who do not respond well to medical treatment. The treatment is relatively safe and effective.
What are the benefits of bronchial thermoplasty?
Bronchial thermoplasty provides significant improvement of symptoms in patients with asthma, but it does not completely cure asthma. The benefits include the following:
- Reduction in asthma attacks
- Reduction in emergency room visits for respiratory symptoms
- Reduction in days lost from work, school or other daily activities due to asthma symptoms
- Reduction in hospitalizations for respiratory symptoms
When can bronchial thermoplasty not be done?
Bronchial thermoplasty is not recommended in following conditions:
- Psychologically unstable patient
- Poor cardiac (heart) status
- Coagulopathy (bleeding disorder)
- Consumption of high-dose steroids
- Severe underlying medical conditions
Factors that increase post-procedure risk include the following:
How is bronchial thermoplasty performed?
Before the procedure
- The surgeon performs a complete physical assessment, along with radiological tests (X-ray, computed tomography scan, angiography) and laboratory tests.
- The patient is advised to quit smoking tobacco before surgery, as smoking delays the healing process.
- The patient is required to fast for up to 12 hours before surgery. Consent for the procedure is obtained prior to surgery.
During the procedure
- Bronchial thermoplasty is performed using a flexible bronchoscope during three separate outpatient procedures three weeks apart.
- Radiofrequency energy is delivered to a wire basket attached to the top of the catheter, in which thermal energy warms the lining of targeted airways to reduce airway smooth muscle mass.
- It helps to reduce, debulk, or partially eliminate smooth muscle tissue.
- The duration of each treatment lasts for about an hour.
After the procedure
- Patients are administered painkillers and antibiotics.
- Patients can go home the same day, three to four hours after the procedure.
What are the complications of bronchial thermoplasty?
The procedure is relatively safe, and complications are rare. Some possible complications are: