What is bronchial thermoplasty (BT)?

Updated: Mar 30, 2021
  • Author: Said A Chaaban, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Bronchial thermoplasty (BT) is a modality for treating asthma and is thought to prevent the chronic structural changes that occur in airway smooth muscle (ASM) in individuals with asthma. [1]  BT targets ASM via the delivery of a controlled specific amount of radiofrequency (RF) energy (RF ablation [RFA]) to the airway wall through a dedicated catheter.

Asthma is a complex inflammatory disorder of the airways characterized by airway hyperresponsiveness (AHR) and variable airflow obstruction. Although advances in clinical and basic research over the past few decades have led to the development of effective treatments and dissemination of detailed disease management guidelines, [2, 3, 4, 5]  difficult-to-treat asthma continues to affect 5-10% of adults with this disorder. [6]

Treating these patients is an ever-evolving challenge and is a major source of frustration for the patients and clinicians alike. Most patients with difficult-to-treat asthma require three or four medications and long-term oral corticosteroids or frequent bursts. [7]  The development of alternative therapies has offered the advantage of avoiding the major side effect of steroids. [8]

Despite these expensive therapies, patients with difficult-to-treat asthma account for a disproportionately high share of asthma-associated morbidity and mortality and continue to experience repeated symptoms, including potentially life-threatening exacerbations. [9]  This population not only is responsible for a large economic cost but also has a large impact on society in terms of missed work or school. [10]


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