How is bronchial thermoplasty (BT) performed?

Updated: Mar 30, 2021
  • Author: Said A Chaaban, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Bronchial thermoplasty (BT) is performed via fiberoptic bronchoscopy in three separate procedures, separated by approximately 3 weeks, as demonstrated by previous studies. [25, 20] Dividing the treatments into three bronchoscopy sessions minimizes the risk of inducing an asthma exacerbation or diffuse airway edema. It also avoids excessive procedural length. BT takes longer (30-60 minutes) than a standard fiberoptic bronchoscopy (5-20 minutes) does, and the longer duration implies the use of larger doses of medication for sedation.

All accessible airways are treated, with the exception of the right middle lobe, because of the theoretical concern about the risk of inducing right-middle-lobe syndrome. [44]

Oxygen delivery should be started via a nasal or oral cannula during the procedure, with appropriate monitoring of vital signs. Heart rate, pulse oximetry, and noninvasive blood pressure should be continuously monitored.

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