Interventional pulmonology in chronic obstructive pulmonary disease.

Area of Science:

• Pulmonology
• Interventional Bronchoscopy
• Respiratory Medicine

Background:

• Chronic obstructive pulmonary disease (COPD) and emphysema cause progressive dyspnea due to airflow limitation and hyperinflation.
• Traditional treatments include pulmonary rehabilitation, pharmacotherapy, oxygen therapy, and ventilation.

Purpose of the Study:

• To review endoscopic treatment approaches for severe COPD and emphysema.
• To summarize mechanisms, complications, and RCT results of endoscopic lung volume reduction (ELVR).

Main Methods:

• Review of randomized controlled trials (RCTs) and other studies on ELVR techniques.
• Analysis of valve implantation, coil implantation, thermal vapor ablation, polymeric lung volume reduction, and lung denervation.

Main Results:

• Endoscopic lung volume reduction (ELVR) techniques aim to reduce hyperinflation.
• Reversible valve implantation benefits emphysema patients without collateral ventilation.
• Non-blocking methods and lung denervation are emerging therapies with ongoing research.

Conclusions:

• Endoscopic therapies are a significant part of severe COPD and emphysema management.
• ELVR techniques offer diverse mechanisms to reduce lung volume and improve symptoms.
• Further RCTs are needed for non-blocking ELVR methods and novel bronchoscopic therapies.