Interventional pulmonology for chronic inflammatory airway diseases

Chronic inflammatory airway diseases, such as chronic bronchitis, chronic obstructive pulmonary disease, emphysema, and bronchial asthma, pose significant healthcare challenges. Interventional treatments offer promise as valuable complements to the optimal medical therapy recommended by the Global Initiative for Chronic Obstructive Lung Disease guideline and the Global Initiative for Asthma guideline. By directly accessing the airways, these minimally invasive procedures enable precise interventions. They encompass a wide range of techniques including bronchial thermoplasty and targeted lung denervation for both chronic obstructive pulmonary disease and severe asthma, bronchoscopic lung volume reduction (including the use of endobronchial valves, coils, and bronchoscopic thermal vapor ablation), airway bypass and peripheral stent placement for emphysema, bronchial rheoplasty and spray cryotherapy for chronic bronchitis, and other emerging methods. These interventional treatments aim to improve patients' symptoms by reducing lung volume, alleviating hyperinflation, eliminating vagal innervation, disrupting hyperplastic goblet cells and thus reducing excessive mucus secretion, and weakening submucosal smooth muscles. This review highlights the potential advantages of interventional treatments for chronic inflammatory airway diseases and discusses relevant techniques tailored to specific disease subtypes. The overall aim is to assist interventional pulmonologists in selecting the most appropriate techniques for individual patients.