Compact delivery pulmonary treatment systems and methods for improving pulmonary function

Abstract

A pulmonary treatment system includes a compact configuration for delivery to a first airway of a patient. An energy delivery system of the pulmonary treatment system delivers energy to target tissue in or along an airway wall of the first airway to reduce airway resistance in a second airway distal to the first airway. The pulmonary treatment system protects tissue in the airway wall of the first airway located between the target tissue and the energy delivery system by at least one of thermodynamically cooling, circulating a liquid coolant through the pulmonary treatment system, and shielding a portion of the energy delivery system.

What is claimed is: 
     
         1 . A pulmonary treatment system, comprising:
 a nerve modification assembly configured to assume a reduced profile for passage through a lumen of an elongate device and positioning in an airway of a patient, the lumen having a diameter less than about 6.0 millimeters, the nerve modification assembly including
 an energy delivery portion configured to generate heat energy at a power density ranging from 0.1 to 2 W/mm 2  in an airway wall of the airway; and 
 a cooling portion configured to remove heat energy at a power density ranging from about 0.1 to about 0.4 W/mm 2  from the airway wall while heat energy is generated in the airway wall by the energy delivery portion. 
   
     
     
         2 . The pulmonary treatment system of  claim 1 , wherein the energy delivery portion includes at least one electrode configured to delivery radio frequency energy to the airway wall. 
     
     
         3 . The pulmonary treatment system of  claim 1 , wherein the energy delivery portion includes at least one transducer configured to delivery ultrasound energy to the airway wall. 
     
     
         4 . The pulmonary treatment system of  claim 1 , wherein the energy delivery portion includes at least one antenna configured to delivery microwave energy to the airway wall. 
     
     
         5 . The pulmonary treatment system of  claim 1 , wherein the cooling portion includes a thermodynamic cooling mechanism. 
     
     
         6 . The pulmonary treatment system of  claim 1 , wherein the cooling portion includes an inflatable member that is in fluid communication with a source of chilled fluid. 
     
     
         7 . The pulmonary treatment system of  claim 1 , wherein the cooling portion includes an inflatable member and a fluid delivery conduit that extends at least partially around a circumference of the inflatable member. 
     
     
         8 . The pulmonary treatment system of  claim 7 , wherein the energy delivery member includes at least one collapsible and expandable electrode coupled to a portion of a fluid delivery conduit. 
     
     
         9 . The pulmonary treatment system of  claim 7 , wherein the electrode is flexible and electrically conductive. 
     
     
         10 . The pulmonary treatment system of  claim 7 , wherein the energy delivery member includes at least one transducer coupled to a portion of a fluid delivery conduit, the transducer configured to delivery ultrasound energy to the airway wall is a collapsible and expandable electrode. 
     
     
         11 . The pulmonary treatment system of  claim 1 , wherein the energy delivery portion is configured to generate heat energy at a power density ranging from 0.3 to 1.0 W/mm 2  in an airway wall of the airway. 
     
     
         12 . The pulmonary treatment system of  claim 11 , wherein the energy delivery portion is configured to generate heat energy at a power density ranging from 0.48 to 0.64 W/mm 2  in an airway wall of the airway. 
     
     
         13 . The pulmonary treatment system of  claim 1 , the cooling portion is configured to remove heat energy at a power density ranging from about 0.025 to about 1.0 W/mm 2  from the airway wall while heat energy is generated in the airway wall by the energy delivery portion. 
     
     
         14 . The pulmonary treatment system of  claim 13 , the cooling portion is configured to remove heat energy at a power density ranging from about 0.1 to about 0.4 W/mm 2  from the airway wall while heat energy is generated in the airway wall by the energy delivery portion. 
     
     
         15 . The pulmonary treatment system of  claim 1  wherein the energy delivery portion is configured to heat nerve tissue at a depth of at least 2 mm in the airway wall to a temperature of at least 50° C. 
     
     
         16 . The pulmonary treatment system of  claim 15  wherein the cooling portion is configured to cool airway wall tissue disposed between the energy delivery portion and the nerve tissue to a temperature of less than 50° C. 
     
     
         17 . A pulmonary treatment system, comprising:
 a nerve modification assembly configured to assume a reduced profile for positioning in an airway of a patient, the reduced profile having a maximum transverse dimension of less than about 6 mm, the nerve modification assembly including:
 an elongated shaft having proximal and distal ends and a fluid delivery lumen; 
 an energy delivery portion coupled to the elongate shaft near the distal end and configured to generate heat energy at a power density ranging from 0.1 to 2 W/mm 2  in an airway wall of the airway; and 
 a cooling portion coupled to the elongate shaft near the distal end and being fluidly coupled to the fluid delivery lumen such that a coolant may be circulated through the cooling portion so as to remove heat energy at a power density ranging from about 0.1 to about 0.4 W/mm 2  from the airway wall while heat energy is generated in the airway wall by the energy delivery portion. 
   
     
     
         18 . The pulmonary treatment system of  claim 17 , wherein the energy delivery portion includes at least one electrode configured to delivery radio frequency energy to the airway wall. 
     
     
         19 . The pulmonary treatment system of  claim 17 , wherein the energy delivery portion includes at least one transducer configured to delivery ultrasound energy to the airway wall. 
     
     
         20 . The pulmonary treatment system of  claim 17 , wherein the energy delivery portion includes at least one antenna configured to delivery microwave energy to the airway wall. 
     
     
         21 . The pulmonary treatment system of  claim 17 , wherein the cooling portion includes an inflatable member that is in fluid communication with a source of chilled fluid via the fluid delivery lumen. 
     
     
         22 . The pulmonary treatment system of  claim 17 , wherein the cooling portion includes an inflatable member and a fluid delivery conduit that extends at least partially around a circumference of the inflatable member. 
     
     
         23 . The pulmonary treatment system of  claim 22 , wherein the energy delivery member includes at least one collapsible and expandable electrode coupled to a portion of a fluid delivery conduit. 
     
     
         24 . The pulmonary treatment system of  claim 22 , wherein the energy delivery member includes at least one transducer coupled to a portion of a fluid delivery conduit, the transducer configured to delivery ultrasound energy to the airway wall is a collapsible and expandable electrode. 
     
     
         25 . The pulmonary treatment system of  claim 17 , wherein the energy delivery portion is configured to generate heat energy at a power density ranging from 0.3 to 1.0 W/mm 2  in an airway wall of the airway. 
     
     
         26 . The pulmonary treatment system of  claim 25 , wherein the energy delivery portion is configured to generate heat energy at a power density ranging from 0.48 to 0.64 W/mm 2  in an airway wall of the airway. 
     
     
         27 . The pulmonary treatment system of  claim 17 , the cooling portion is configured to remove heat energy at a power density ranging from about 0.025 to about 1.0 W/mm 2  from the airway wall while heat energy is generated in the airway wall by the energy delivery portion. 
     
     
         28 . The pulmonary treatment system of  claim 27 , the cooling portion is configured to remove heat energy at a power density ranging from about 0.1 to about 0.4 W/mm 2  from the airway wall while heat energy is generated in the airway wall by the energy delivery portion. 
     
     
         29 . The pulmonary treatment system of  claim 17 , wherein the energy delivery portion is configured to heat nerve tissue at a depth of at least 2 mm in the airway wall to a temperature of at least 50° C. 
     
     
         30 . The pulmonary treatment system of  claim 29  wherein the cooling portion is configured to cool airway wall tissue disposed between the energy delivery portion and the nerve tissue to a temperature of less than 50° C.