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.