Bronchial Thermoplasty

Abstract

Treatment of severe asthma refractory to standard therapies such as inhaled corticosteroids or bronchodilators is limited. Newer pharmacologic agents focus on the allergic subset of asthmatics limiting their use to a smaller subgroup. Bronchial thermoplasty is a novel procedure developed over the past decade where airway smooth muscles are ablated using radiofrequency thermal energy during bronchoscopy to prevent bronchoconstriction. Current data suggest that the procedure is relatively safe with a potential for transient and mild worsening of respiratory symptoms. Bronchial thermoplasty has shown a significant decrease in the number of exacerbations and emergency department visits during the year following therapy. While FDA approved since 2010 for refractory asthma not responding to conventional therapies, some individual health plans are yet to approve it for reimbursement limiting its wide use. Current guidelines endorse cautionary use until further data is available regarding the efficacy of the procedure.

Keywords: Allergic subset, Asthma refractory, Bronchial thermoplasty, Bronchoconstriction, Bronchodilators, Exacerbations, Inhaled corticosteroids.

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