Bronchial thermoplasty for severe asthma

2.1 Asthma is a long-term condition of the airways in the lungs that affects children, young people and adults. It consists of inflammation and constriction of the smooth muscle in the airway walls (bronchoconstriction). This is triggered by increased responsiveness of the airways to various allergic stimuli, leading to airflow obstruction. Symptoms include recurring episodes of wheezing, breathlessness, chest-tightness and coughing.

2.2 Asthma is diagnosed and its severity assessed on the basis of symptoms and objective tests of lung function.

2.3 Treatment, including advice about lifestyle changes, aims to reduce the frequency and severity of attacks, allowing the person to lead a normal and active life. In the UK, treatment for asthma follows NICE's guideline on asthma and guidelines from the Global Initiative for Asthma.

2.4 The aim of bronchial thermoplasty for severe asthma is to reduce the smooth muscle mass lining the airways, decreasing their ability to constrict.

2.5 The procedure is usually done using sedation or general anaesthesia. A catheter is introduced into the bronchial tree. Short pulses of radiofrequency energy are applied circumferentially to sequential portions of the airway wall, moving from the distal to the proximal bronchi. Treatment is usually delivered in 3 sessions with an interval of at least 3 weeks between each session. After the first session, treated airways are evaluated by bronchoscopy before proceeding with further treatment.