Bronchial thermoplasty is a nonpharmacological
treatment for severe
asthma that delivers
thermal energy to the bronchial walls and reduces hypertrophied
smooth muscle mass. Previous studies have shown its
efficacy and
safety, resulting in approval from the
Food and Drug Administration in 2010. In
Korea, the first
bronchial thermoplasty was carried out in 2014; 4
patients have undergone the
procedure so far. This case series presents the medical
history and
treatment outcomes of these 4
patients. All
patients presented with uncontrolled
asthma despite optimal medical
treatment.
Bronchial thermoplasty was performed at the right lower lobe, left lower lobe, and both upper lobes in order at 3-week intervals. All
procedures were performed under
general anesthesia. Two
patients had significant decreases in exacerbations and required a lower
dose of inhaled
corticosteroids after the
procedure. One
patient had slightly fewer exacerbations but failed to reduce the use of systemic
corticosteroids. One
patient had no change in symptoms. One limitation of
bronchial thermoplasty is the difficulty of predicting clinical responders. However, since more
therapeutic options are needed in the management of severe
asthma, especially T2-low
asthma, discussion with experts about the feasibility and necessity of
bronchial thermoplasty will ensure the best possible care.