Clinical pearls for bronchial thermoplasty

The development of bronchial thermoplasty, an investigational outpatient bronchoscopic procedure for asthma, has captured the interest of the interventional pulmonologist. Promising early clinical studies have demonstrated that bronchial thermoplasty may result in an improvement in asthma control. Bronchial thermoplasty involves the controlled delivery of radiofrequency electrical energy to the airway wall via a special catheter electrode array. Bronchial thermoplasty is performed under conscious sedation and typically results in a bronchoscopy that is longer in duration than most currently performed bronchoscopic procedures. Effective patient management is, therefore, critically important to maximize patient comfort and safety. We describe our technique for bronchial thermoplasty, highlighting the importance of bronchoscopy experience, careful patient selection, patient preparation, patient management, and postoperative follow-up.