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Bronchoscopic interventions for emphysema: Current status

Chronic obstructive pulmonary disease is a prevalent and progressive disease. The recently developed bronchoscopic lung volume reduction (BLVR) techniques offer personalized therapeutic options in subgroups of patients with severe emphysema. Endobronchial and intrabronchial valves (EBV/IBV) achieve...

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Autores principales: Wang, Ran, Paul, Suman, Truong, Vi, Munavvar, Mohammed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879872/
https://www.ncbi.nlm.nih.gov/pubmed/33154215
http://dx.doi.org/10.4103/lungindia.lungindia_8_20
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author Wang, Ran
Paul, Suman
Truong, Vi
Munavvar, Mohammed
author_facet Wang, Ran
Paul, Suman
Truong, Vi
Munavvar, Mohammed
author_sort Wang, Ran
collection PubMed
description Chronic obstructive pulmonary disease is a prevalent and progressive disease. The recently developed bronchoscopic lung volume reduction (BLVR) techniques offer personalized therapeutic options in subgroups of patients with severe emphysema. Endobronchial and intrabronchial valves (EBV/IBV) achieve lung volume reduction by lobar atelectasis. The lung volume reduction coils (LVRCs) and bronchoscopic thermal vapor ablation (BTVA) induce tissue compression, either mechanically or through inflammatory processes. While the effects of EBV/IBV are reversible by removing the implants, the effects of LVRC are partially reversible and that of BTVA is irreversible. The presence of interlobar collateral ventilation (CV) impacts on EBV/IBV treatment outcome due to its mechanism of action. Therefore, using radiological and endoscopic techniques to assess CV has a vital importance. Current evidence of BLVR demonstrates acceptable safety and short-term clinical efficacy. However, head-to-head trials are lacking, and further research is needed to establish long-term clinical benefit, durability, and cost-effectiveness of these techniques.
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spelling pubmed-78798722021-02-23 Bronchoscopic interventions for emphysema: Current status Wang, Ran Paul, Suman Truong, Vi Munavvar, Mohammed Lung India Review Article Chronic obstructive pulmonary disease is a prevalent and progressive disease. The recently developed bronchoscopic lung volume reduction (BLVR) techniques offer personalized therapeutic options in subgroups of patients with severe emphysema. Endobronchial and intrabronchial valves (EBV/IBV) achieve lung volume reduction by lobar atelectasis. The lung volume reduction coils (LVRCs) and bronchoscopic thermal vapor ablation (BTVA) induce tissue compression, either mechanically or through inflammatory processes. While the effects of EBV/IBV are reversible by removing the implants, the effects of LVRC are partially reversible and that of BTVA is irreversible. The presence of interlobar collateral ventilation (CV) impacts on EBV/IBV treatment outcome due to its mechanism of action. Therefore, using radiological and endoscopic techniques to assess CV has a vital importance. Current evidence of BLVR demonstrates acceptable safety and short-term clinical efficacy. However, head-to-head trials are lacking, and further research is needed to establish long-term clinical benefit, durability, and cost-effectiveness of these techniques. Wolters Kluwer - Medknow 2020 2020-10-30 /pmc/articles/PMC7879872/ /pubmed/33154215 http://dx.doi.org/10.4103/lungindia.lungindia_8_20 Text en Copyright: © 2020 Indian Chest Society http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Wang, Ran
Paul, Suman
Truong, Vi
Munavvar, Mohammed
Bronchoscopic interventions for emphysema: Current status
title Bronchoscopic interventions for emphysema: Current status
title_full Bronchoscopic interventions for emphysema: Current status
title_fullStr Bronchoscopic interventions for emphysema: Current status
title_full_unstemmed Bronchoscopic interventions for emphysema: Current status
title_short Bronchoscopic interventions for emphysema: Current status
title_sort bronchoscopic interventions for emphysema: current status
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879872/
https://www.ncbi.nlm.nih.gov/pubmed/33154215
http://dx.doi.org/10.4103/lungindia.lungindia_8_20
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