1Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, 2Division of Foregut and Thoracic Surgery, 3Cardiopulmonary Services, University of Minnesota, Minneapolis, MN, USA . Correspondence to: Felix Zamora, MD. Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, 420 Delaware St. SE, MMC 276, Minneapolis, MN 55455, USA. Email: zamo0038@umn.edu.
Abstract: Asthma is an incurable chronic disease affecting approximately 24 million people in the United States. The hallmark features of asthma are reversible airflow obstruction, airway hyperresponsiveness, airway inflammation, bronchoconstriction, and excessive mucus secretion. Clinical symptoms include episodic or persistent breathlessness, wheezing, cough, or chest tightness/pressure. Forty-five percent of asthmatics continue to have yearly exacerbations and the disease is responsible for approximately 3,600 annual deaths. Pharmacologic advancements have continued to grow as the individual phenotypes of asthma are better delineated but there continues to be small population of asthmatics that are less responsive to pharmacologic therapy. Bronchial thermoplasty (BT) is an innovative procedure targeted primarily at decreasing airway smooth muscle (ASM) which is considered by some to be a vestigial organ. Decreasing the ASM bulk decreases hyperresponsiveness and bronchoconstriction leading to decreased exacerbations, decreased cost on the healthcare system, and improvement in patient quality of life.