Endoscopic Methods for Lung Volume Reduction

Chapter

Abstract

Pulmonary emphysema is a chronic, debilitating, often fatal disease, characterized by progressive destruction of the lung parenchyma, hyperinflation, and impaired gas exchange. Medical treatment for emphysema offers limited symptomatic relief and with the exception of smoking cessation has failed to improve survival. Surgical lung volume reduction, however, proved to be an alternative to medical therapies capable of prolonging survival in a selected group of patients with emphysema. Endoscopic methods of lung volume reduction (ELVR) have been developed in order to provide a minimally invasive alternative to the surgical procedure. Some procedures rely on device insertion, including endobronchial valves, coils, and bypass stents, while others instill bioactive substances such as a polymer or water vapor with identical therapeutic intentions. The methods are diverse, but are usually applied using the flexible bronchoscope, and may target one or both lungs. Complications are few but include COPD exacerbations and occasionally pneumothoraces among the most feared. Thus far, ELVR has proven successful in improving the quality of life of a minority of patients with severe emphysema and continues to be the object of intense scientific scrutiny. Results from recent studies confirm the overall safety of various procedures and offer a glimpse of potential benefits, although surgical outcomes thus far have not been matched.

Keywords

Placebo Catheter Europe Expense Pneumothorax 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.IIS-Fundación Jimenez Diaz -CIBERESMadridSpain

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