Bronchial thermoplasty is an U.S. Food and Drug Administration-approved medical procedure that treats severe, persistent asthma. It uses heat to shrink the smooth muscle in the lungs that tightens during asthma attacks and makes it hard to breathe. Doctors perform the procedure on patients 18 years and older whose asthma is not well controlled with standard treatments such as inhaled corticosteroids and long-acting beta2-agonist bronchodilators.

The procedure, performed on patients under sedation or anesthesia, involves endoscopy, meaning the physician inserts a small flexible tube into the airway to deliver the heat in specific places of the smooth muscle. Three sessions of bronchial thermoplasty three weeks apart are needed to complete the procedure.

Some patients may experience an improvement in their quality of life for five years or longer and also a small reduction in the number of asthma flare-ups. However, health experts agree the procedure’s limited benefits do not sufficiently outweigh the risks for most patients 18 and older, even for those whose asthma is not well controlled.

Potential severe short-term risks include:

• Worsening asthma
• Respiratory infections
• Coughing up blood

The long-term risks are unknown because only a small number of patients have been studied for long periods. Bronchial thermoplasty is not recommended for anyone younger than 18 because it has not been studied in this age group.

Before you consider bronchial thermoplasty, your doctor should first make sure that you have been using the asthma medications as they were prescribed and that you have tried other types of treatment shown to improve asthma. Optimal therapy may significantly reduce your symptoms.

You may want to consider the procedure, in close consultation with your doctor and other members of your care team, only if you:

• Are 18 or older and have been diagnosed with persistent asthma.
• Are willing to risk short-term worsening of symptoms and unknown long-term side effects.

If you decide to undergo bronchial thermoplasty, select an experienced provider, such as a pulmonologist with training in the procedure. If you can, participate in a research program that enrolls participants in registries, conducts ongoing clinical trials, or tracks the procedure’s long-term safety and effectiveness.