NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
Status In progress
Process IP
ID number 1437
Description In COPD, acetylcholine released from parasympathetic airway nerve fibres mediates smooth muscle tone, reflex bronchoconstriction, mucus hyper-secretion and airway inflammation. This procedure disrupts parasympathetic signalling to the lungs and decreases neuronal release of acetylcholine. The aim is to produce permanent bronchodilation, decrease mucus production and improve breathing. Endobronchial nerve ablation is a minimally invasive outpatient procedure carried out under general anaesthesia. A bronchoscope is used to visualise the airways and a dual-cooled radiofrequency (RF) catheter, which has a balloon and an electrode on the end, is positioned in the distal mainstem bronchus. Once in position, coolant is passed through the catheter and the balloon inflates, pressing the electrode against the airway wall. RF energy is then delivered from the electrode to ablate the parasympathetic nerves that run along the outside of the mainstem bronchus. The balloon is then deflated and rotated, and the ablation repeated until the whole circumference of the bronchus has been treated. Both main bronchi are treated during a single procedure. Most patients return home on the day of the procedure.

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Key events during the development of the guidance:

Date Update
22 July 2021 - 19 August 2021 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance