Abstract: Systems, assemblies, and methods to treat pulmonary diseases are used to decrease nervous system input to distal regions of the bronchial tree within the lungs. Treatment systems damage nerve tissue to temporarily or permanently decrease nervous system input. The treatment systems are capable of heating nerve tissue, cooling the nerve tissue, delivering a flowable substance that cause trauma to the nerve tissue, puncturing the nerve tissue, tearing the nerve tissue, cutting the nerve tissue, applying pressure to the nerve tissue, applying ultrasound to the nerve tissue, applying ionizing radiation to the nerve tissue, disrupting cell membranes of nerve tissue with electrical energy, or delivering long acting nerve blocking chemicals to the nerve tissue.

Abstract: Methods and systems for ablating target tissue, such as in or along an airway, include modulation one of power and current of an a system to achieve a treatment output or parameter. Treatment outputs can include current, power, energy delivered, percent drop in impedance, an impedance-based ratio, a percent impedance slope, and/or an airway wall impedance. Power and/or current of the system can be varied, within certain maximum thresholds, such as power, current, and/or impedance thresholds, to achieve the desired output parameter target during some or all of the treatment time. The systems and methods reduce the variability of the treatment efficacy otherwise due to variability in electrical properties of patient tissue and/or electrode contact.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering energy to nerve tissue in a target region such that at least a portion of the nerve tissue is replaced by scar tissue or otherwise altered to inhibit reinnervation in the target region.

Abstract: A pulmonary treatment catheter and handle system including a catheter assembly with insertion tube coupled to a handle assembly. The system is further removably coupleable to a delivery device, such as a flexible bronchoscope or endoscope, having a port for coupling the handle assembly thereto, and a working channel in communication with the port for delivering the catheter assembly through the delivery device and into a body lumen. Optionally, a port channel of the port can be collinear with the working channel of the delivery device. The catheter assembly, handle assembly, and delivery device cooperate together to facilitate delivery and positioning of a catheter electrode in a treatment site, such as an airway, conduit, or vessel for treatment of the tissue, while minimizing damage to portions of the catheter assembly, the delivery device, or both.

Abstract: A system and method can be used to denervate at least a portion of a bronchial tree. An energy emitter of an instrument is percutaneously delivered to a treatment site and outputs energy to damage nerve tissue of the bronchial tree. The denervation procedure can be performed without damaging non-targeted tissue. Minimally invasive methods can be used to open airways to improve lung function in subjects with COPD, asthma, or the like. Different sections of the bronchial tree can be denervated while leaving airways intact to reduce recovery times.

Abstract: A pulmonary treatment system includes a compact configuration for delivery to an airway of a patient. An energy delivery system of the pulmonary treatment system delivers ultrasound energy to target nerve tissue in or along an airway wall of the airway radially outward from surface tissue to reduce airway resistance in a downstream airway. The pulmonary treatment system may protect tissue in the airway wall of the airway located between the target nerve tissue and the ultrasound energy delivery system by a coolant system that may also act as a coupling fluid for the emitted ultrasound energy.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input. The system, delivery devices, and methods can damage tissue and manage scarring and stenosis.

Abstract: A medication delivery device for treatment of a pulmonary disorder in a patient includes an elongate member, an expandable member is coupled to a distal end of the elongate member, and an agent delivery portion coupled to an external surface of the expandable member. The agent delivery portion includes an agent that disrupts nerve activity.

Abstract: A method of reducing bronchial constriction in a subject includes delivering energy to create one or more lesions on a main bronchus so as to transect pulmonary nerves sufficiently to reduce bronchial constriction in a lung of the patient distal to the main bronchus.

Abstract: Apparatus and methods for providing intrabronchial delivery of a treatment fluid to control the effects of a bronchial condition. The apparatus can include a shaft having proximal and distal ends and a fluid injection assembly disposed on the distal end. The fluid injection assembly can be a deployable needle assembly, a rotating needle assembly, a needle-less injection assembly, or a nebulizer assembly.

Abstract: The present disclosure provides methods for improving drug efficacy in a patient having an obstructed airway in a lung. Such methods modulate nerve activity in the autonomic nervous system of a patient to reduce obstruction of an airway in a lung of the patient prior to administering a drug to the patient. These methods are especially useful in improving efficacies of bronchodilators in treating obstructive lung diseases, such as chronic obstructive pulmonary disease.

Abstract: Methods and systems for ablating target tissue, such as in or along an airway, include modulation one of power and current of an a system to achieve a treatment output or parameter. Treatment outputs can include current, power, energy delivered, percent drop in impedance, an impedance-based ratio, a percent impedance slope, and/or an airway wall impedance. Power and/or current of the system can be varied, within certain maximum thresholds, such as power, current, and/or impedance thresholds, to achieve the desired output parameter target during some or all of the treatment time. The systems and methods reduce the variability of the treatment efficacy otherwise due to variability in electrical properties of patient tissue and/or electrode contact.

Abstract: A system and method can be used to denervate at least a portion of a bronchial tree. An energy emitter of an instrument is percutaneously delivered to a treatment site and outputs energy to damage nerve tissue of the bronchial tree. The denervation procedure can be performed without damaging non-targeted tissue. Minimally invasive methods can be used to open airways to improve lung function in subjects with COPD, asthma, or the like. Different sections of the bronchial tree can be denervated while leaving airways intact to reduce recovery times.

Abstract: Devices and methods for treating one or more pulmonary diseases while avoiding or minimizing injury to the esophagus and branches of the vagus nerve that run along the outside of the esophagus. The device includes at least one energy delivery element disposed on an elongate member and a means for protecting the esophagus and surrounding tissues, such as esophageal branches of the vagus nerve, during treatment. The energy delivery element is positionable to target at least one nerve in or around the tracheal wall when the elongate member is positioned in the trachea. Energy from the energy delivery element is delivered to the at least one nerve to treat pulmonary symptoms, conditions, and/or diseases, such as asthma, COPD, obstructive lung diseases, or other pulmonary diseases, while the protection means protects the esophagus and surrounding tissues from permanent damage.

Abstract: A treatment system includes a fluid cooling supply system for chilling and delivering liquid coolant to a patient. The fluid cooling supply system includes a cooling device and a heat exchanger device. The heat exchanger device is biased to the cooling device and is in fluid communication with a treatment device in a patient. The fluid cooling supply system includes at least one biasing mechanism to provide a given biasing force between the heat exchanger device and the cooling device to effectuate and improve heat transfer. The liquid coolant may be circulated through an energy delivery device positioned in an airway of a patient to preserve tissue. The system is controlled to circulate liquid coolant at a given temperature and pressure for a selected amount of time during pulmonary treatment of a patient.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input. The system, delivery devices, and methods can damage tissue and manage scarring and stenosis.

Abstract: A method of reducing bronchial constriction in a subject includes delivering energy to create one or more lesions on a main bronchus so as to transect pulmonary nerves sufficiently to reduce bronchial constriction in a lung of the patient distal to the main bronchus.

Abstract: A treatment system includes a fluid cooling supply system for chilling and delivering liquid coolant to a patient. The fluid cooling supply system includes a cooling device and a heat exchanger device. The heat exchanger device is biased to the cooling device and is in fluid communication with a treatment device in a patient. The fluid cooling supply system includes at least one biasing mechanism to provide a given biasing force between the heat exchanger device and the cooling device to effectuate and improve heat transfer. The liquid coolant may be circulated through an energy delivery device positioned in an airway of a patient to preserve tissue. The system is controlled to circulate liquid coolant at a given temperature and pressure for a selected amount of time during pulmonary treatment of a patient.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input. The system, delivery devices, and methods can damage tissue and manage scarring and stenosis.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect nerve tissue such that reinnervation is inhibited. The treatment systems are capable of delivering energy to nerve tissue in a target region such that at least a portion of the nerve tissue is replaced by scar tissue or otherwise altered to inhibit reinnervation in the target region.