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Semin Respir Crit Care Med
DOI: 10.1055/s-0044-1787876
Review Article

Bronchoscopic Lung Volume Reduction: A Review

Shreya Podder
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
,
Marium Khan
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
,
Zane Sink
2   Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina
,
Steven Verga
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
3   Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin
,
Jonathan S. Kurman
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
3   Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin
,
Elizabeth Malsin
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
3   Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin
› Author Affiliations
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Abstract

Bronchoscopic lung volume reduction (BLVR) is an established treatment modality for the management of advanced chronic obstructive pulmonary disease complicated by severe emphysema and hyperinflation refractory to other therapies. BLVR aims to reduce hyperinflation and residual volume, thereby improving pulmonary function, symptom control, and quality of life. Multiple distinct devices and technologies, including endobronchial coils, thermal vapor ablation, bio-lung volume reduction, and airway bypass stenting, have been developed to achieve lung volume reduction with varying degrees of accessibility and evidence. The most promising BLVR treatment modality to date has been the placement of one-way endobronchial valves (EBVs), with more than 25,000 cases performed worldwide. Identifying symptomatic patients who would benefit from BLVR is challenging and can be time and resource intensive, and candidacy may be limited by physiologic parameters. Additional new technologies may be able to improve the identification and evaluation of candidates as well as increase the portion of evaluated patients who ultimately qualify for BLVR. In this review, we aim to provide historical context to BLVR, summarize the available evidence regarding its use, discuss potential complications, and provide readers with a clear guide to patient selection and referral for BLVR, with a focus on EBV placement. In addition, we will highlight potential future directions for the field.

Keywords

lung volume reduction - endobronchial valves - emphysema - COPD - hyperinflation - dyspnea


Publication History

Article published online:
18 July 2024

© 2024. Thieme. All rights reserved.

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