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Endoscopic Lung Volume Reduction: An Expert Panel Recommendation - Update 2017.

Felix J F Herth¹, Dirk-Jan Slebos, Gerard J Criner

¹Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.

Respiration; International Review of Thoracic Diseases

|August 18, 2017

Summary

Endoscopic lung volume reduction (ELVR) offers new hope for emphysema patients. Expert recommendations are updated for selecting patients and using techniques like valves, coils, and ablation to improve breathing.

Keywords:

Bronchoscopy Chronic obstructive pulmonary disease Emphysema Expert statement Hyperinflation Lung volume reduction

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Area of Science:

Pulmonology
Interventional Bronchoscopy
Respiratory Medicine

Background:

Growing interest in endoscopic lung volume reduction (ELVR) technologies for emphysema management.
Several ELVR techniques (valves, coils, thermal vapor ablation) have been evaluated in randomized controlled trials.
These interventions aim to improve respiratory mechanics and alleviate chronic dyspnea in emphysema patients.

Purpose of the Study:

To update best practice recommendations for patient selection in ELVR.
To provide guidance on the utilization of various ELVR techniques for advanced emphysema.
To consolidate expert opinion on the evolving field of endoscopic lung volume reduction.

Main Methods:

Review of recent randomized controlled trials on ELVR technologies.
Expert consensus on patient selection criteria for ELVR.
Guidance on the application of different endoscopic techniques including valves, coils, and thermal vapor ablation.
Emphasis on comprehensive baseline assessment including imaging and functional testing.

Main Results:

Patients with severe air trapping and thoracic hyperinflation show the greatest potential benefit from ELVR.
Comprehensive baseline assessment is crucial for optimal patient selection.
Updated recommendations cover the selection and utilization of diverse ELVR methods.

Conclusions:

ELVR technologies are a rapidly advancing area for emphysema treatment.
Careful patient selection based on detailed assessment is paramount for successful ELVR outcomes.
These updated recommendations aim to guide clinicians in optimizing the use of ELVR for advanced emphysema.