COPD-Associated Expiratory Central Airway Collapse: Current Concepts and New Perspectives

Area of Science:

• Pulmonary Medicine
• Respiratory Diseases
• Airway Disorders

Background:

• COPD-associated expiratory central airway collapse (ECAC) is an underdiagnosed benign airway obstructive disease.
• Pathologic and physiologic mechanisms of ECAC remain unclear.
• Diagnosis and treatment of ECAC present significant challenges.

Purpose of the Study:

• To provide a systematic evaluation of COPD-associated ECAC.
• To review epidemiologic features, causes, and pathophysiology.
• To discuss clinical manifestations, diagnosis, and treatment strategies.

Main Methods:

• Systematic review of existing literature.
• Evaluation of diagnostic techniques including bronchoscopy and dynamic biphasic CT imaging.
• Assessment of therapeutic interventions such as noninvasive ventilation, airway stenting, and tracheobronchoplasty.

Main Results:

• Bronchoscopy is the gold standard for ECAC diagnosis; dynamic biphasic CT is a noninvasive alternative.
• Noninvasive ventilation offers long-term benefits; temporary stents manage acute symptoms.
• Tracheobronchoplasty shows therapeutic effects but has perioperative risks; long-term efficacy needs study.

Conclusions:

• ECAC diagnosis and management remain challenging despite growing attention.
• Further research, including randomized controlled trials and cost-effective analyses, is essential.
• Development of consensus guidelines for COPD-associated ECAC is urgently needed.