Bronchial thermoplasty for severe asthma

The aim of bronchial thermoplasty for severe asthma is to reduce airway smooth muscle mass, thereby decreasing the ability of the airways to constrict.

• bronchial thermoplasty is usually performed with the patient under sedation or general anaesthesia.
  • a specially designed catheter is introduced into the bronchial tree
  • short pulses of radiofrequency energy are applied circumferentially to sequential portions of the airway wall, moving from distal (diameter > 3 mm) to proximal (main bronchi) at 5 mm intervals
  • treatment is usually delivered in 3 sessions with an interval of at least 3 weeks between each session. After the first treatment session, previously treated airways are evaluated by bronchoscopy before proceeding with further treatment

NICE have suggested that "..Evidence on the efficacy of bronchial thermoplasty for severe asthma shows some improvement in symptoms and quality of life, and reduced exacerbations and admission to hospital. Evidence on safety is adequate in the short and medium term. More evidence is required on the safety of the procedure in the long term. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.."

Reference:

• 1) NICE (January 2012). Bronchial thermoplasty for severe asthma