Novel modalities and agents in bronchoscopic lung volume reduction

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Thoracic Surgery

Background:

• Lung volume reduction surgery (LVRS) is effective for severe emphysema but invasive.
• Bronchoscopic lung volume reduction (BLVR) techniques have emerged as less invasive alternatives.
• Emphysema treatment aims to improve functional parameters and exercise tolerance.

Purpose of the Study:

• To review the various bronchoscopic lung volume reduction (BLVR) techniques.
• To compare the safety and efficacy of BLVR methods to traditional LVRS.
• To discuss the potential of BLVR as a revolutionary approach for severe lung emphysema.

Main Methods:

• Review of existing literature on bronchoscopic lung volume reduction techniques.
• Description of methods including airway bypass, endobronchial valves, coils, ablation, and sealants.
• Discussion of patient selection and stratification for BLVR.

Main Results:

• BLVR methods are generally simpler, safer, and less costly than surgical LVRS.
• Endobronchial valves show promise in specific emphysema phenotypes and are reversible.
• Parenchymal interventions may benefit a broader patient group, offering permanent effects.

Conclusions:

• BLVR techniques offer a promising, less invasive approach to managing severe emphysema.
• Further multicentre studies are needed to optimize patient selection and confirm safety and effectiveness.
• BLVR represents a potentially revolutionary advancement in emphysema treatment.