Abstract
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits.
The Global Initiative for Asthma (GINA) recommendations state that BT can be provided to adult asthma patients at step 5 (by GINA). Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit.
Patient selection for BT demands close collaboration between interventional pulmonologists and severe asthma centers. BT uses temperature-controlled radiofrequency (RF) energy to impact airway remodeling, including a reduction of excessive airway smooth muscle within the airway wall, which has been recognized as a predominant feature of asthma.
The long-term safety of BT is excellent. An optimalisation of BT responder profile - i.e., which specific asthma phenotype benefits most - is a topic of current research.