Method and apparatus for pulmonary interventions

Apparatus for treating pulmonary conditions in a mammalian subject, comprising:

• an ultrasound transducer adapted for insertion into and activation in a bronchial section of the mammalian subject and for emitting ultrasound energy in the bronchial section adapted to inactivate conduction of bronchial nerves alongside the bronchial section;
• and
• an actuator or control unit electrically connected to the ultrasound transducer, the actuator or control unit being configured to control the ultrasound transducer to transmit ultrasound energy into an impact volume at least partially surrounding the bronchial section, the ultrasound energy being in an amount effective to inactivate conduction of bronchial nerves throughout the impact volume,
• wherein the actuator or control unit is configured to control the ultrasound transducer to:
• energize the ultrasound transducer to emit a pulse at a sub-therapeutic level while the ultrasound transducer is disposed proximate to a treatment site in the bronchial section;
• receive, via the ultrasound transducer, ultrasound echoes from organic tissues of the mammalian subject in response to the pulse;
• process and analyze a volume-integrated A-mode signal from the ultrasound transducer, representing an accumulated intensity of the ultrasound echoes,
• measure a time delay of the volume integrated A-mode signal and therewith determine size of the bronchial section;
• and
• control the ultrasound transducer to vary the amount of the therapeutically effective ultrasound energy in accordance with the determined size of the bronchial section taking into account efficiency variations.

Apparatus for treating bronchial conditions in a mammalian subject, comprising:

• an ultrasound transducer adapted for insertion into and activation in a bronchus of the mammalian subject and for emitting ultrasound energy in the bronchus adapted to inactivate conduction of bronchial nerves alongside the bronchus;
• and
• an actuator or control unit electrically connected to the ultrasound transducer, the actuator or control unit being configured to control the ultrasound transducer to transmit ultrasound energy into an impact volume at least partially surrounding the bronchus, the ultrasound energy being in an amount effective to inactivate conduction of bronchial nerves throughout the impact volume,
• wherein the actuator or control unit is configured to control the ultrasound transducer to:
• energize the ultrasound transducer to emit a pulse at a sub-therapeutic level while the ultrasound transducer is disposed proximate to a treatment site in the bronchus;
• receive, via the ultrasound transducer, ultrasound echoes from organic tissues of the mammalian subject in response to the pulse;
• process and analyze a volume-integrated A-mode signal from the ultrasound transducer, representing an accumulated intensity of the ultrasound echoes, to determine one or more locations along the bronchus for treatment;
• and
• activate the ultrasound transducer to transmit ultrasound therapeutic waveform energy through a wall of the bronchus at the one or more locations along the bronchus,
• wherein the ultrasound transducer is disposed inside a balloon configured to receive cooling fluid during the activating of the ultrasound transducer, wherein the actuator or control unit is further configured to measure cooling fluid volume and pressure and to determine a point of rapid pressure increase without significant volume increase which corresponds with a lumen size of the bronchus at a treatment site and to adjust ultrasound energy accordingly.