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Clinical Pearls for Bronchial Thermoplasty

Mayse, Martin L. MD*; Laviolette, Michel MD; Rubin, Adalberto S. MD; Lampron, Noel MD; Simoff, Michael MD§; Duhamel, David MD; Musani, Ali I. MD; Yung, Rex C. MD; Mehta, Atul C. MD**

Journal of Bronchology & Interventional Pulmonology: April 2007 - Volume 14 - Issue 2 - p 115-123
doi: 10.1097/LBR.0b013e318054dbed
How I Do It

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.

*Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO

Laval Hospital, Laval University, Quebec, Canada

Irmandade Santa Casa de Misericórdia, Porto Allegre, Brazil

§Henry Ford Health Systems, Detroit, MI

Virginia Hospital Center, Arlington, VA

Hospital of the University of Pennsylvania, Philadelphia, PA

Johns Hopkins Medical Center, Baltimore, MD

**Cleveland Clinic Foundation, Cleveland, OH

There is no conflict of interest.

Supported by Asthmatx, Inc, Mountain View, CA.

All authors are investigators in an ongoing clinical study on bronchial thermoplasty (AIR2) sponsored by Asthmatx, Inc. No authors are employees, stock holders, consultants, or advisors of Asthmatx and no authors have any other financial interest in the company.

Alair and Asthmatx are registered trademarks of Asthmatx, Inc.

Reprints: Martin L. Mayse, MD, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 660 S Euclid Avenue, Campus Box 8052, St Louis, MO 63110 (e-mail:

Received for publication February 20, 2007; accepted March 1, 2007

© 2007 Lippincott Williams & Wilkins, Inc.