Bronchial Thermoplasty

What is bronchial thermoplasty?

Bronchial thermoplasty is a procedure that can help treat severe asthma. A healthcare provider (usually a pulmonologist) uses a thin tube to apply heat to the muscles around your airways, thinning them. Most people need three procedures to treat all areas of their lungs.

If you have asthma, inflammation and contraction of the smooth muscles in your lungs make it hard to breathe, especially during an attack (exacerbation). Bronchial thermoplasty can give you more room to breathe and reduce your risk of an attack.

Who is a candidate for bronchial thermoplasty?

You might be a candidate for bronchial thermoplasty if you have severe asthma that isn’t manageable with standard treatments, like inhalers, oral medications or biologics. Severe asthma can mean you have:

• Symptoms that are hard to manage or interfere with your quality of life.
• Frequent asthma attacks.
• Severe exacerbations that require you to be treated in a hospital.

How do I prepare for bronchial thermoplasty?

To prepare for the procedure, your provider may ask you to:

• Not eat or drink anything for at least eight hours beforehand.
• Take an oral steroid for two to three days leading up to the procedure.
• Arrange to have someone drive you home after the procedure.

What happens during bronchial thermoplasty?

During bronchial thermoplasty, a healthcare provider will:

1. Give you anesthesia through an IV to keep you comfortable (asleep) during the procedure.
2. Insert a bronchoscope (thin tube) through your mouth and into your lungs.
3. Apply heat (in the form of radiofrequency energy) to parts of your airways where the muscle is thickened.
4. Remove the bronchoscope.

Each thermoplasty procedure takes about 45 minutes to an hour.

What happens after bronchial thermoplasty?

After the procedure, healthcare providers will monitor you for at least a few hours as you wake up and recover. If you have worsening symptoms or side effects, you may need to spend the night in the hospital.

How long will I need bronchial thermoplasty?

You’ll need three thermoplasty treatments to treat all areas of your lungs. Your provider will treat a different area of your lung in each procedure — your right and left lower lobes are treated in two different sessions, and both of your upper lobes are treated together in a third session. (Your right middle lobe isn’t treated to avoid the risk of collapse.) The sessions take place at least three weeks apart.

What are the potential benefits of bronchial thermoplasty?

Bronchial thermoplasty can reduce the severity or frequency of your asthma symptoms. You might be less likely to have asthma attacks after the procedure.

But bronchial thermoplasty doesn’t cure asthma. You’ll still need medication to help manage your symptoms.

What are the risks of bronchial thermoplasty?

Risks of bronchial thermoplasty include:

• Hospitalization due to severe symptoms.
• Infection.
• Atelectasis (collapse of part of your lung).
• Bronchiectasis (widening of your airways or development of pouches).

Does bronchial thermoplasty cause side effects?

Some people have new symptoms or symptoms that get worse in the days following the treatment, including:

• Cough.
• Shortness of breath.
• Chest pain or discomfort.

These symptoms usually get better within a week of the procedure. Ask your provider what to expect and when to contact them or go to the emergency room.

How long will it take for me to feel better after bronchial thermoplasty treatment?

Some people start to see symptom improvement soon after their first treatment. Others might not see improvement until recovering from all three treatments, or only see minor improvements.

What is the success rate of bronchial thermoplasty?

In one study, bronchial thermoplasty reduced airway smooth muscle mass by 53% in people who had the procedure. Other studies suggest bronchial thermoplasty could improve the quality of life for people with severe asthma and reduce the number of exacerbations. 

How long does a bronchial thermoplasty last?

Studies suggest that the positive effects of bronchial thermoplasty — like improved quality of life and reduced exacerbations — last at least 10 years. As the treatment is still relatively new, there haven’t been studies to see if the effects last longer than that yet.

When should I call my healthcare provider?

Contact your healthcare provider about any concerns you have before or after the procedure.

Go to the emergency room if you experience:

• Difficulty breathing.
• Chest pain.
• Fever.
• Coughing up blood.