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(Chest. 2004;126:238-248.)
© 2004 American College of Chest Physicians

Innovative Approaches to Lung Volume Reduction for Emphysema*

Matt Brenner, MD, FCCP; Nevine Mikhail Hanna, BS; Reza Mina-Araghi, MD; Arthur F. Gelb, MD, FCCP; Robert J. McKenna, Jr, MD and Henri Colt, MD

* From the Divisions of Pulmonary Medicine and Beckman Laser Institute, University of California Irvine Medical Center, Orange, CA (Drs. Brenner, Mina-Araghi, and Colt, and Mr. Hanna); Lakewood Regional Medical Center (Dr. Gelb), Lakewood, CA; and the Department of Thoracic Surgery (Dr. McKenna), Cedars Sinai, Orange, CA.

Correspondence to: Matt Brenner, MD, FCCP, Associate Professor of Medicine, Pulmonary and Critical Care Division, UC Irvine Medical Center, Bldg 53, Rm 119, 101 City Dr South, Orange, CA 92868; e-mail: mbrenner{at}uci.edu

The 10 years of resurgent interest in lung volume reduction surgery (LVRS) and recent National Emphysema Treatment Trial findings for emphysema have stimulated a range of innovative alternative ideas aimed at improving outcomes and reducing complications associated with current LVRS techniques. Concepts being actively investigated at this time include surgical resection with compression/banding devices, endobronchial blockers, sealants, obstructing devices and valves, and bronchial bypass methods. These novel approaches are reaching the stage of clinical trials at this time. Theory, design issues, methods, potential advantages and limitations, and available results are presented. Extensive research in the near future will help to determine the potential clinical applicability of these new approaches to the treatment of emphysema symptoms.

Key Words: emphysema • endobronchial fenestration • lung volume reduction surgery • plugs • reducers




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