Bronchial thermoplasty

Overview

Bronchial thermoplasty offers relief for severe asthma by targeting the smooth muscle in the lungs. When traditional treatments fail to manage severe asthma, this procedure becomes an alternative.

Asthma involves persistent inflammation of the airways, leading to swelling of the smooth muscle lining the lungs during episodes, making breathing difficult. Bronchial thermoplasty employs heat to shrink this smooth muscle, reducing the likelihood of muscle tightening that could trigger an asthma attack. The treatment typically consists of three sessions, spaced three weeks apart, administered by a pulmonologist, a specialist in lung health. Each session focuses on treating a different area of the lungs, aiming to alleviate asthma symptoms and improve quality of life.

Reasons for undergoing the procedure

Adults with severe asthma are the only patients for which bronchial thermoplasty is permitted. Five to ten percent of asthmatics have severe asthma that is uncontrollable with medications, inhalers, or other treatments.

In order to treat asthma inflammation, your healthcare provider will initially look into alternatives. This treatment may be appropriate for a subset of individuals with severe asthma.

Bronchial thermoplasty is a relatively new therapy that is still undergoing evaluation to establish its efficacy. The few advantages might not outweigh the potential risks for a large number of people. It is up to you and your healthcare provider to determine whether this treatment is necessary for your severe asthma.

Risks

For many individuals, the uncertainties and potential risks associated with bronchial thermoplasty may outweigh its perceived benefits. Only a small percentage of patients have been monitored by researchers for extended periods of time after treatment. Healthcare providers are not yet aware of every potential long-term harm.

The following are considered as short-term side effect that could become serious.

• Asthma symptoms becomes worse.
• Coughing up blood.
• Respiratory infections.

Before the procedure

Your healthcare provider will prescribe an oral steroid for you to take two days before the procedure, on the day of the procedure, and for two days afterward. This medication is aimed at reducing swelling in the lungs.

During the procedure

On the day of the procedure, you’ll visit the hospital where bronchial thermoplasty is typically conducted as an outpatient treatment. Unless there are severe adverse reactions, you won’t need to stay overnight.

During the procedure, you’ll be unconscious, either deeply asleep or under a milder anesthetic. Your healthcare provider will use a bronchoscope, a small, flexible tube inserted through your mouth or nose and into your lungs. The smooth muscle of your lungs will then receive thermal heat through this catheter.

After the procedure

Your healthcare provider will keep an eye on you for a few hours following the surgery to look for any negative effects. Should the surgery cause your asthma symptoms to worsen, you might have to stay overnight in the hospital.

Asthma cannot be cured by bronchial thermoplasty. You will still need to take asthma medicine to assist manage symptoms after the treatment.

Outcome

Bronchial thermoplasty offers potential benefits in reducing both the frequency and severity of asthma attacks. This may lead to a decreased reliance on medications, particularly steroids, or a need for lower doses, although ongoing asthma medication is still typically necessary. Additionally, if you frequently experience severe asthma attacks requiring hospitalization, bronchial thermoplasty might help reduce hospital visits and decrease the number of sick days taken from work or school.

Following the procedure, it’s common to experience some irritation in the lungs for a few days. You may also encounter symptoms resembling asthma, such as chest tightness or shortness of breath. Your healthcare provider can discuss treatment options for managing these symptoms, such as the appropriate use of your inhaler.

While some individuals have reported improvements in their overall quality of life and symptom relief lasting up to five years, the long-term effects of bronchial thermoplasty are still being studied as it is a relatively new treatment.

Seek medical attention with your healthcare provider if you encounter the following:

• Chest tightness.
• Coughing up blood.
• Breathing problem.
• Asthma symptoms worsen.