[Bronchoscopic Lung Volume Reduction for Severe Emphysema]

Bronchoscopic lung volume reduction (BLVR) using endobronchial valves is a minimally invasive treatment for severe emphysema. Although lung volume reduction surgery( LVRS) has been employed in selected patients, its high complication rate and limited functional improvement have led to a shift toward non-surgical options. In September 2024, we performed our first BLVR procedure in a transplant candidate who met all eligibility criteria. The patient showed improvement in symptoms and pulmonary function. However, case recruitment remains challenging due to the strict inclusion criteria and limited awareness of BLVR. We report our initial clinical experience, highlight issues in patient selection and recruitment, and discuss the potential of BLVR as a bridging therapy for lung transplantation. In addition, we emphasize its possible utility in elderly or inoperable patients with advanced chronic obstructive pulmonary disease (COPD). Broader dissemination and revision of current eligibility criteria may facilitate wider adoption of this promising therapy.