Bronchial Thermoplasty: A New Therapeutic Option in Severe Uncontrolled Asthma

Bronchial thermoplasty (BT) is a new endoscopic treatment approved by the US Food and Drug Administration (FDA) in the management of severe refractory asthma involving the delivery of controlled, therapeutic radiofrequency (RF) energy to the airway wall. It is based on the premise of controlling bronchospasm through a reduction of airway smooth muscle (ASM). Several clinical trials have demonstrated improvements in asthma-related quality of life and a reduction in the number of exacerbations following treatment with BT. However, several questions remain regarding the use of BT, mechanism of action, selection of appropriate patients, and long-term effects. Further studies are expected to elucidate the underlying mechanisms that result in these improvements. This chapter discusses key aspects of BT with a focus on the potential clinical effects of this promising procedure. It also offers insight into the barriers to implementing a successful BT program and strategies for overcoming them.