The goal of the targeted lung denervation procedure is to disrupt pulmonary nerve input to the lung to reduce clinical consequences of neural hyperactivity. Denervation of the lung interrupts vagus nerve signaling to and from the lung. Disruption of this signaling causes a decrease in basal parasympathetic tone throughout the lung which supports bronchodilation through relaxation of smooth muscle and decrease in mucous secretion of airway submucosal glands. The concept is thus to move the pulmonary system from a state of heightened neural activity which is associated with increased exacerbations and symptom burden, to a state of attenuated neural activity, to decrease exacerbations and symptoms.
COPD before TLD
COPD after TLD
For an overview of TLD mechanism of action, please click here.
The dNerva® Lung Denervation System
The dNerva® Lung Denervation System consists of a console and the dNerva dual-cooled radiofrequency (RF) catheter. The console delivers the RF energy required to ablate the pulmonary nerves. The console includes a thermoelectric plate and pump that cools the fluid (dextrose 5% in water) circulating through the dNerva catheter to protect the airway wall during energy delivery, and a graphical user interface with a prompt screen to control the console and guide the user.
Nuvaira® Lung Denervation System
dNerva® Dual Cooled RF Catheter
The dNerva dual-cooled catheter is a specialized, patented disposable component consisting of an umbilical that connects to the console, and a handle and shaft that are compatible with most flexible bronchoscopes utilizing a 3.2mm working channel. The distal balloon and electrode assembly have been designed to collapse to fit through the bronchoscope’s working channel.