Evaluation of Safety and Effectiveness of TLD Radiofrequency Ablation in the Treatment of COPD

Inclusion Criteria:

1. Participants aged ≥40 and ≤ 75 years;
2. Diagnosis of COPD with post-bronchodilator PFT parameters FEV1/FVC<70% and 20% ≤ FEV1 ≤ 60% of predicted; if FEV1<30%pred, PaCO2≤50mmHg;
3. CAT ≥ 10 or mMRC ≥2;
4. Non-smoking for a minimum of 2 months prior to consent and agrees to not smoke for theduration of the clinical investigation;
5. Recent participation in a formal pulmonary rehabilitation program should have occurred ≥3 months prior to consent; if participants are currently enrolled in a maintenanceprogram, they should agree to continue their current program through their 12-monthfollow-up visit;
6. Documented history of taking standard medication (consistent with GOLDguideline<2022>) for ≥12 months at the time of consent;
7. Received an influenza vaccine within the 12 months prior to consent or agrees toobtain an influenza vaccine during the clinical investigation, and agrees to annualinfluenza vaccines for the duration of the clinical investigation;
8. Resting SpO2 ≥ 89% at the time of screening;
9. Willing, able, and agrees to complete all protocol required baseline and follow-uptesting assessments including finishing the Patient Diary;
10. Able to understand the purpose of the clinical investigation, agree to participate inthe trial and able to complete the informed consent signature.

Exclusion Criteria:

1. BMI < 18 or > 35;
2. Asthma as defined by the GINA guideline (2022);
3. Patient has been previously diagnosed with a non-COPD active lung disease (e.g.,active tuberculosis);
4. Patient has a medical history of pneumothorax;
5. Known contraindication or allergy to medications required for bronchoscopy or generalanesthesia that cannot be medically controlled;
6. Recent respiratory infections or COPD exacerbation in preceding 4 weeks;
7. Malignancy treated with radiation or chemotherapy within 2 years of consent;
8. Daily use of > 10 mg of prednisone or its equivalent at the time of consent;
9. Recent (within 3 months of consent) opioid use;
10. Known gastrointestinal motility disorder or previous abdominal surgical procedure onstomach, esophagus, or pancreas
11. Has an implantable electronic device;
12. Previous or planned pulmonary or thoracic surgery (including but not limited to:pneumonectomy, lung transplantation, pulmonary medical device intervention < e.g.pulmonary valve implantation, bronchial thermal ablation (BT), etc. >) during thistrial;
13. Myocardial infarction within last 6 months, EKG with evidence of life-threateningarrhythmias or acute ischemia, pre-existing documented evidence of a LVEF < 45%, stageC or D (ACC/AHA) or Class III or IV (NYHA) congestive heart failure, or any othercardiac findings that make the participant an unacceptable candidate for abronchoscopic procedure utilizing general anesthesia;
14. High risk of pulmonary hypertension according to clinical assessment, defined aspulmonary artery systolic pressure estimated by echocardiogram to be > 50 mmHg;
15. Pulmonary nodule or other lesions thought to be at high risk of malignancy;
16. Clinically relevant bronchiectasis, defined as severe single lobe or multilobarbronchial wall thickening associated with airway dilation on CT scan leading to cough,intractable expectoration and repeated hemoptysis lasting for several days;
17. In the opinion of the Investigator, use of the TLD devices is not feasible, forexample, due to screening chest CT scan reveals severe emphysema or bronchi anatomycannot be fully treated with available catheter sizes: severe bullous disease (> 1/3hemithorax) or site discovery of a mass that requires treatment;
18. A GCSI total symptom score ≥ 18.0 prior to treatment;
19. Any disease or condition that might interfere with completion of a procedure or thisstudy (e.g., life expectancy< 1 years);
20. Women of childbearing potential must have a negative pregnancy test (blood or urine)pre-treatment and agree not to become pregnant for the duration of the study
21. Participated in any clinical trial and received experimental treatment within 3 monthsbefore the screening visit.