Bronchial thermoplasty

Bronchial thermoplasty helps open up the airways making breathing easier for people with severe asthma

What is bronchial thermoplasty? 

Bronchial thermoplasty is a medical procedure that some people with severe asthma can have to help open their airways.

It’s a heat treatment that reduces the amount of thickened smooth muscle on the inside walls of the airways.

See the video below for an animation of the treatment.

Who might benefit from bronchial thermoplasty?

Bronchial thermoplasty will only be considered as a treatment option for you if you’re over 18 and you have severe asthma not controlled with the usual asthma treatments.

Although bronchial thermoplasty can have benefits for some people with severe asthma, more research is needed to understand the long-term effects, and which patients will benefit the most. It might be that just a small number of people with severe asthma will benefit from it.

It’s important that you get the chance to talk it through with your asthma consultant, so you can decide if bronchial thermoplasty is right for you or not.

If your consultant doesn’t think you’ll benefit from it, you can talk through other treatment options. For example, there are new medicines for severe asthma called monoclonal antibodies.

How does bronchial thermoplasty help severe asthma?

Over time, severe asthma causes the smooth muscle tissue lining the airways to thicken. This means the airways are narrower and it’s harder to breathe.

Bronchial thermoplasty removes some of this thickened muscle tissue and opens up your airways. It also makes your airways less likely to contract and narrow in the future.  

This means you’ll have fewer asthma attacks and hospital visits and should be able to breathe more easily.

What are the risks of bronchial thermoplasty?

The most common short-term risk is that your asthma symptoms get worse before they get better. Sometimes this means you’ll have to stay in hospital after the procedure.

The long-term risks and benefits of bronchial thermoplasty aren’t yet fully understood. This is because it hasn’t been around for a long time, and the procedure hasn’t been carried out on enough people to get a full picture of the benefits.  

Your specialist will be able to talk you through any safety concerns and risks so you can both decide if this treatment is right for you.

What does the bronchial thermoplasty procedure involve?

You’ll need to visit a hospital or specialist centre as an out-patient to have bronchial thermoplasty.

If you’ve ever had a bronchoscopy, where a tiny camera is passed down into your airways to look at them, bronchial thermoplasty is a very similar procedure:

  • You’ll usually be sedated, to keep you comfortable and relaxed as possible. Sometimes the procedure is done under general anaesthetic. 
  • A very fine, flexible tube is passed through your nose or mouth and down into the airways inside your lungs. It has a tiny camera on the end, so the specialist can see exactly what they’re doing.
  • A special wire is then passed down through this tube into the airways.
  • This delivers short, 10 second, pulses of heat treatment to the walls of the airways. The heat produced – which is about the same temperature as a warm cup of tea – reduces the excess smooth muscle tissue in your airways.  
  • One session treats a third of the target area and takes about 30 to 60 minutes.
  • After the first session, your specialist will look at the treated airway before they decide whether or not to continue with the next treatment.
  • Most people will have three separate sessions for complete treatment, with about three weeks between each session.

[Video] Bronchial thermoplasty for asthma

After your bronchial thermoplasty treatment

After the procedure, you can usually go home the same day, as long as your specialist is happy everything’s gone well.

You’ll need to allow for three to four hours recovery time though, and occasionally people will need to stay overnight.

The most common side effect is that your asthma symptoms get worse, for example wheezing, and chest discomfort, although these usually clear within a week with your usual asthma medicines. A few patients may need to stay in hospital if symptoms are severe.

Make sure you know how to manage any symptoms that get worse after your procedure, and what to do if you have any symptoms you weren’t expecting.

Questions to ask your asthma consultant about bronchial thermoplasty

If you’ve been offered bronchial thermoplasty, it’s important that you get the chance to talk it through with your asthma consultant, so you can decide if it’s right for you or not.

You should be given some written information about the procedure, including any risks and what to expect afterwards, so you can give your informed consent (agreement) to have the procedure.

Here are some questions you could think about asking:

  • What does the treatment involve?
  • What are the benefits I can expect?
  • What are my chances of getting those benefits?
  • Will I still need to keep taking my other asthma medicines?
  • Could having the treatment make me feel worse?
  • Are there alternative treatment options?
  • What are the risks of the treatment?
  • Are the risks minor or serious?
  • How likely are they to happen?
  • What care will I need after the treatment?
  • What happens if something goes wrong?
  • What happens if I decide not to have the treatment?

Need more advice?

If you want to find out more about bronchial thermoplasty, talk to your GP or your asthma specialist.

You can also talk to one of our asthma nurse specialists on our Helpline on 0300 222 5800 (9am-5pm; Mon-Fri).

Or you can WhatsApp them on 07378 606 728.

Last updated February 2019

Next review due February 2022