The Procedure

Targeted Lung Denervation (TLD) is a one-time non-surgical procedure that involves passing a specialized catheter through a bronchoscope in order to complete a full circumferential ablation in the mainstem bronchus of each lung.

The bronchoscope is inserted into the mainstem bronchi and a radio-opague esophageal balloon is inserted to facilitate visualization and avoidance of treatment in close proximity to the esophagus.

Step 1 is to thread the dNerva catheter through the working channel of the bronchoscope and position it in the distal aspect of the mainstem bronchi.

Step 2 is to inflate the conduit and balloon by circulating coolant through the catheter which brings the electrode in contact with the airway wall.

Step 3 is to visually confirm good contact of the electrode with the airway wall and adequate distance from the esophagus (confirmed under fluoroscopy).

Step 4 is to activate the RF energy.

After completion of the activation, the physician will rotate the catheter 90 degrees and then repeat.

Each mainstream bronchus is treated 4 times to complete circumferential ablation and thus deliver a full treatment.