Bronchoscopic lung volume reduction: A new treatment modality for patients with severe emphysema

Bronchoscopic lung volume reduction
COPD is a progressive lung disease, which can be prevented and treated, but only symptomatically, not curative. COPD is a major cause of chronic morbidity and mortality worldwide. According to World Health Organization estimates, 65 million people suffer from COPD and it will become the third leading cause of death by 2020. The current treatment of COPD offers only limited benefit to patients with severe COPD. A very small subset of these COPD patients will benefit from either lung transplantation or lung volume reduction surgery, but these treatments are highly invasive, scarcely available, and expensive. Therefore, less invasive procedures for lung volume reduction have been developed. In this thesis we investigated two novel bronchoscopic treatments in patients with advanced emphysema; endobronchial valve treatment and lung volume reduction coil treatment. The key message of this thesis is that bronchoscopic treatment with endobronchial valves in selected patients with emphysema significantly improves pulmonary function, exercise capacity, and quality of life. The endobronchial valve treatment can be considered as an additional treatment option next to optimal conventional medical treatment for patients with COPD and with very severe emphysema preselected to have proven absence of interlobar collateral ventilation. For patients who are not qualified for endobronchial valve treatment the coil-treatment has been shown to be a valid treatment option. However, its real efficacy and safety profile needs to be further evaluated in randomized controlled trials with larger sample sizes and longer follow-up.