New frontiers in bronchoscopic lung volume reduction for the treatment of severe emphysema

In recent decades, bronchoscopic lung volume reduction (BLVR) has shown to be a valuable therapeutic option for a select group of patients with severe emphysema and significant hyperinflation. These treatments can lead to a reduction in symptoms, improve exercise capacity, and improve quality of life.
One-way valve treatment is one of the most researched bronchoscopic lung volume reduction options. In this thesis, we have demonstrated that the characteristics of the treated lung lobe are the most important predictors of treatment resposnse. Furthermore, treated patients can expierence a loss of treatment effect and in this thesis we have shown that the formation of granulation tissue is the main cause of this loss of treatment effect.
For patients who are not eligible for one-way valve treatment, lung volume reduction coils can be an alternative. A meta-analysis revealed that this treatment leads to improvements in lung function, exercise capacity, and quality of life, although the results vary greatly between patients. Unfortunately, research into a second-generation coil did not show better outcomes.