Bronchial thermoplasty is a procedure that applies directed heat to the airway walls, reducing the bulk of airway smooth muscle and thereby reducing the potential for airway constriction. The procedure may also affect airway nerves and inflammatory cells. The device used to administer bronchial thermoplasty was registered in Australia in 2013.
The procedure requires three bronchoscopy procedures and can be complicated by acute asthma exacerbations during the treatment period.
Bronchial thermoplasty does not improve overall lung function, and a sham-controlled study showed a large placebo effect, but it may reduce the severity and number of exacerbations. Most studies of this procedure have been conducted in patients with moderate asthma rather than severe asthma. Limited long-term safety data exist for this procedure.
The ATS / ERS guidelines recommend that all treatments occur in the context of an Institutional Review Board-approved systematic registry or clinical study (Chung et al. 2014). This recommendation is based on the current lack of understanding of which patients may benefit from bronchial thermoplasty, and which do not, and because of limited long-term safety data.