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Bronchial Thermoplasty - A New Procedure for Severe Asthma

Bronchial Thermoplasty is a an outpatient bronchoscope procedure that delivers heat to the airway walls in the lungs, which has been shown to limit the ability of the airway smooth muscles to constrict and narrow the airways.  As a result, patients treated with bronchial thermoplasty have been shown to have a decrease in severe asthma attacks and improved quality of life.

About Severe Asthma

What happens when you have severe Asthma?

Air travels in and out of your lungs through airways, which are tubes. There are tiny muscles in the walls of airways.  People who have severe asthma have larger muscles in their airways than other people.  The airways close down when these muscles contract

What happens when your airways close down?

When airways close down it can be harder to breathe.  Your chest may feel tight.  You may wheeze or cough.  Asthma medicines usually open the airways.  These medicines do not always work well in patients with severe asthma.

Who qualifies for this treatment?

People who have severe asthma. Your asthma is severe because the asthma drugs you are taking now do not control your asthma symptoms.

Your doctor may use a treatment called Bronchial Thermoplasty (BT).  Bronchial Thermoplasty is a procedure and not an asthma medication. 

What is Bronchial Thermoplasty

With this procedure, a device will mildly heat your airway walls.  This heating reduces some of the extra muscle present in the airways.  This will allow your airways to open and help you breathe better.

Who should have this treatment?

This treatment is for those who have severe persistent asthma that are 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long acting beta agonists.

Who cannot have this treatment?

You cannot have this treatment if you have:

  • An implant with electronics, such as a pacemaker.  The BT may keep the implant from working correctly.
  • Problems taking certain medicines.  If you have ever had a problem taking any kind of medicines, you doctor will need to ensure that the medicine he or she uses will not hurt you.
  • Have had this treatment before.  Discuss with your doctor that you have had the Bronchial Thermoplasty before.
  • You cannot have this treatment if you are less than 18 years old.  No one has tested BT in patients younger than 18 years.

What will happen if you decide to have the BT treatment for your severe asthma?

There will be 3 treatments.  There will be 3 weeks in between each treatment.

  • You will prepare for each treatment by taking 50-mg steroid pill by mouth once a day for 3 days before the treatment.
  • You will also take a 50-mg steroid pill on the day of the treatment.
  • On each BT treatment day, your doctor will test your lungs. This will be done by checking how much air you can blow out.
  • Your doctor will make sure you don’t have an infection.  An infection would delay the treatment.
  • Your doctor will tell you what he or she will be doing during the BT.

Your doctor will:

  1. Give you medicines to make you sleepy
  2. Put a small tube called a bronchoscope through your mouth into your airways
  3. Put a small tube through the bronchoscope. The wires on its end will touch your airways
  4. Heat the wires on the end of the small tube to reduce some of the airway muscle tissue.  You won’t feel this because your doctor gave you medicine.
  5. Move the small tube to more places and treat them the same way
  6. Take the small tube and the bronchoscope out
  7. Watch over you as you wake up and recover

What happens after each BT treatment?

  • You have to take a 50-mg steroid pill for the day.
  • Your doctor will contact you by phone to check on you
  • You will still have to take your asthma medicine

After your airways heal from your first treatment, you will go back to your doctor for your second treatment.  Your doctor will treat more of your airways. After you get well from that, your doctor will treat the rest of your airways in your third treatment.

Use your rescue inhaler, if your asthma symptoms get bad. Tell your doctor if you needed to use your rescue inhaler.

Patient Frequently Asked Questions

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