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Lung India Official publication of Indian Chest Society  
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Year : 2020  |  Volume : 37  |  Issue : 6  |  Page : 518-529

Bronchoscopic interventions for emphysema: Current status

1 School of Biological Sciences, The University of Manchester, Manchester, United Kingdom
2 Department of Respiratory, Lancashire Teaching Hospital NHS Foundation Trust, Preston, United Kingdom
3 School of Biological Sciences, The University of Manchester, Manchester; Department of Respiratory, Lancashire Teaching Hospital NHS Foundation Trust, Preston, United Kingdom

Correspondence Address:
Dr. Mohammed Munavvar
Lancashire Teaching Hospital NHS Foundation Trust, Sharoe Green Lane, Fulwood, Preston, PR2 9HT
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/lungindia.lungindia_8_20

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Chronic obstructive pulmonary disease is a prevalent and progressive disease. The recently developed bronchoscopic lung volume reduction (BLVR) techniques offer personalized therapeutic options in subgroups of patients with severe emphysema. Endobronchial and intrabronchial valves (EBV/IBV) achieve lung volume reduction by lobar atelectasis. The lung volume reduction coils (LVRCs) and bronchoscopic thermal vapor ablation (BTVA) induce tissue compression, either mechanically or through inflammatory processes. While the effects of EBV/IBV are reversible by removing the implants, the effects of LVRC are partially reversible and that of BTVA is irreversible. The presence of interlobar collateral ventilation (CV) impacts on EBV/IBV treatment outcome due to its mechanism of action. Therefore, using radiological and endoscopic techniques to assess CV has a vital importance. Current evidence of BLVR demonstrates acceptable safety and short-term clinical efficacy. However, head-to-head trials are lacking, and further research is needed to establish long-term clinical benefit, durability, and cost-effectiveness of these techniques.

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