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Emerging Interventional Pulmonary Therapies for Chronic Obstructive Pulmonary Disease

Rabin, Alexander S. MD*; Keyes, Colleen M. MD; Oberg, Catherine L. MD; Folch, Erik E. MD

doi: 10.1097/RTI.0000000000000424
Symposium: Imaging of Innovative and Contemporary Thoracic Interventions: State-of-the-Art
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Chronic obstructive pulmonary disease is a condition characterized by progressive airflow limitation caused by airway and parenchymal inflammation. Current medical therapies, including bronchodilators, corticosteroids, and anti-inflammatory medications, have been shown to variably improve pulmonary function or quality of life without providing a long-term mortality benefit. Mortality benefits to therapy have been demonstrated in only 2 therapeutic interventions to date: long-term use of daily supplemental oxygen and surgical lung volume reduction (LVRS) for upper-lobe–predominant disease in patients with a low baseline exercise capacity. Newer bronchoscopic techniques for lung volume reduction (bLVR) have attracted interest from clinicians and researchers. To achieve successful results, these advanced therapies require an interdisciplinary approach between general and interventional pulmonologists and thoracic radiologists. In this article, we aim to review the latest interventional pulmonary techniques for treatment of chronic obstructive pulmonary disease with an emphasis on bLVR. We will review the bLVR preprocedure imaging evaluation, postprocedure imaging findings, and explore the potential benefits and risks of therapy based on the most recent clinical trial evidence.

*Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center

Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA

E.E.F. has served as a scientific consultant for Boston Scientific and Medtronic. The remaining authors declare no conflicts of interest.

Correspondence to: Erik E. Folch, MD, 55 Fruit Street, Bulfinch 148, Boston, MA 02114 (e-mail: efolch@mgh.harvard.edu).

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