Bronchial thermoplasty is a new, innovative procedure for the treatment of severe asthma. It helps to reduce the smooth muscle mass and thus, widen the airways that are narrowed during asthma attacks. Bronchial thermoplasty does not cure asthma but helps to relieve the symptoms of asthma and enables a patient to breathe easily.

Ideal candidates for bronchial thermoplasty

For undergoing bronchial thermoplasty, a patient should fulfill the following criteria:

• Should be between the age group of 18 to 65 years
• Should have severe asthma attacks that are not being controlled by asthma medications and inhalers
• Individuals who have not smoked since a year

Who is not the right candidate for bronchial thermoplasty?

The following patients are not eligible for bronchial thermoplasty:

• Individuals who were previously treated with bronchial thermoplasty.
• People with an internal defibrillator, artificial pacemaker, or any other implantable electronic devices.
• People who are sensitive to the medications used during the procedure, such as lidocaine, atropine, and benzodiazepines.

Benefits of bronchial thermoplasty

The benefits of bronchial thermoplasty are as follows:

• Reduces the number of asthma attacks
• Improves symptoms for nearly 5 years after the treatment
• Minimizes the emergency hospital visits
• Less number of days lost from school, work, and other physical activities

Procedure for bronchial thermoplasty

Bronchial thermoplasty treatment is given in three short sessions, which are performed at a pace of three weeks between each session. It is an outpatient procedure and each session lasts for approximately less than an hour.

Before the procedure

The following are the important steps to be taken care before undergoing bronchial thermoplasty:

• The doctor will brief you about the procedure and the risks associated with bronchial thermoplasty.
• Inform the doctor in prior, if you have an internal defibrillator, artificial pacemaker, or any other implanted devices.
• Talk to the doctor regarding the medications, as you might be advised to stop taking certain medications, such as blood-thinning drugs before few days of the procedure.
• The doctor would advise you to stop tobacco smoking and alcohol consumption prior to the procedure.
• You would be advised to stop eating and drinking liquids at least 8 hours before the procedure.

During the procedure

Bronchial thermoplasty is a simple procedure, which involves the following steps:

• Before beginning the procedure, an intravenous line would be started, and sedatives would be given to make you go off to sleep. A local anesthesia would be applied on your nose and throat to make them numb. Sometimes, general anesthesia may be administered.
• Now, a thin, flexible tube-like instrument known as a bronchoscope that is attached to a video camera at its end is passed through the nose or mouth into the airways.
• Then a small wire is passed through the tube into the airways.
• This special wire delivers heat and warms up the walls of the airways that are constricted. It helps to reduce the surplus of smooth muscle tissue present in the airways.
• The heat produced is as mild as a warm cup of tea and hence, you won’t feel that the tube is touching the lungs.
• Each session treats one-third of the target area and usually takes around 1 hour for completion.
• Upon completion of the first session, the doctor checks the treated airway and decides whether further treatment is essential or not.
• Usually, most of the people would require three sessions with a gap of three weeks to complete the treatment.

After the procedure

• After the procedure, you would be monitored for 2 to 4 hours at the hospital.
• A family member or a known person should accompany you and you may go home on the same day of the procedure.
• You will have to attend the next scheduled bronchial thermoplasty in 2 to 3 weeks after the first session of treatment.

Side effects of bronchial thermoplasty

The side effects of this procedure are very rare. If present, they usually go away in a week. They are:

• Cough
• Wheezing
• Shortness of breath