Bronchial thermoplasty

Bronchial thermoplasty is surgery to treat severe asthma that hasn’t improved with other therapies. During an asthma attack, the smooth muscle around your airways tightens and makes it hard to breathe. Bronchial thermoplasty applies heat to the muscle to cause it to shrink, which opens your airways and makes it easier to breathe. Your doctor performs this minimally invasive procedure by guiding a thin tube called a bronchoscope into your lungs. It usually takes three procedures to get the full benefit.

Penn Medicine has a team of interventional pulmonology experts dedicated to treating asthma. Our specialists use a wide range of tests to diagnose your condition and have experience treating even the most complex asthma cases. Bronchial thermoplasty is done by physicians who are skilled at performing bronchoscopies. They work closely with your entire team of providers to bring you complete care. Our goal is to help you live with fewer and less severe asthma attacks.

Not everyone with asthma may benefit from bronchial thermoplasty. This procedure might be right for you if:

• You’re an adult who has severe asthma attacks that occur frequently.
• Other treatments haven’t improved your symptoms.
• Asthma affects your quality of life.

You’ll need to take an oral steroid medication starting a few days before your procedure. Your health care team will let you know how many hours you need to stop eating and drinking before your appointment. Because you’ll go home the same day, arrange for someone to drive you home afterward.

During this procedure:

• You’ll be given numbing spray in your throat and medication to make you comfortable, known as sedation. Or you may be given general anesthesia to put you to sleep.
• Your doctor will place the bronchoscope into your mouth and will gently guide it down your throat and into your lungs.
• Using a catheter that delivers radiofrequency energy, your doctor heats parts of your airways where your smooth muscle is thickened.
• Your doctor then removes the bronchoscope.

After your procedure, you’ll be monitored for a few hours before you go home. The surgery is done three times, typically a few weeks apart, to target different areas in your airways. Although bronchial thermoplasty surgery should help improve your asthma symptoms, it’s not a cure and you’ll continue to need asthma medications.

Bronchial thermoplasty can worsen your asthma symptoms for about a week, which may be serious enough that you need to be treated in the hospital. The surgery can also have complications that can be treated, like an infection, damage to the airways, or the collapse of part of your lung. Talk to your doctor about the possible side effects of bronchial thermoplasty and whether the treatment is the right procedure for you.

Penn Medicine’s asthma team includes pulmonary and allergy specialists who can diagnose your condition and recommend advanced therapies to relieve your symptoms. As an academic institution conducting research on asthma, our experts have a deep understanding of the condition and the most effective therapies.

If bronchial thermoplasty is recommended, our specialists are highly experienced in performing this surgery. We’re home to one of the oldest and largest interventional pulmonology programs in the United States, where experts perform bronchoscopies and other minimally invasive procedures. The expertise our specialists bring to your care means you’ll get the therapies you need to help relieve your symptoms and live with fewer asthma attacks.