Herth FJF Slebos DJ, Criner GJ, Valipour A, Sciurba F, Shah PL.
Respiration. 2019 Mar 5:1-10. doi: 10.1159/000496122. [Epub ahead of print]
Endoscopic lung volume reduction (ELVR) therapies are gaining prominence as a
treatment option with guideline recommendations by COPD GOLD and NICE and the
recent FDA approval for endobronchial valves. The transition from an
experiment-based therapy only to clinical care comes with new challenges. A
significant volume of evidence-based data has been published; all data
demonstrate consistent improvements in several aspects of patient outcomes.
Patients suffering from severe air trapping and thoracic hyperinflation seem to
benefit the most from ELVR. In addition to lung function, baseline assessment
should ideally include cardiopulmonary exercise testing, high-resolution computer
tomography scan, perfusion scintigraphy, and echocardiography. This expert ELVR
statement updates best practice recommendations from 2017 regarding patient
selection and utilization of these various techniques for treating patients with
advanced emphysema.