Currently, there is a great deal of interest in new and developing technologies that allow physicians to perform endoscopic LVRS (ELVRS).9–10 The devices receiving most attention are endobronchial valves that are placed via a bronchoscope. The valves are placed in targeted lobes with the aim of causing atelectasis, thereby reducing the volume of the thoracic cavity, and restoring a more favorable alignment of the respiratory muscle system. The hope is that patients undergoing ELVRS may achieve all of the benefit that surgical patients in the NETT achieved with very little risk. In this issue of CHEST (see page 518), Wan and colleagues11 report their experience using endobronchial valves to perform ELVRS in patients with radiographic evidence of heterogeneous disease and persistent dyspnea despite maximal medical therapy. Their study was a multicenter trial, with nine centers participating from seven countries. All patients underwent ELVRS, and the baseline data were employed to determine if ELVRS was beneficial. Study end points included change in FEV1, FVC, residual volume, and exercise tolerance as assessed by a 6-min walk test. Results are reported up to 90 days after ELVRS was performed. The most significant changes were a 10.7% overall improvement in FEV1 and a 23% improvement in exercise capacity. Comparing these results to those of the NETT is difficult for the following reasons: (1) the NETT reported results from 6 months, 12 months, and 24 months; (2) improvements in FEV1 and exercise tolerance decreased over time in the NETT; and (3) NETT results were reported in histograms for patient groups. The NETT, for example, reported that 65% of patients in the surgical group had an improvement in FEV1 6 months after LVRS and that improvement averaged approximately 11%. Wan et al,11 report that 8 of their 98 patients (8.2%) had serious complications: death, n = 1; pneumothorax requiring surgery, n = 3; and prolonged air leak, n = 4. Additionally, the authors observed other complications in 30 patients, including 5 pneumonias and 17 exacerbations of COPD. Finally, the authors performed a subset analysis and noted that patients treated with valves targeting one lobe or valves placed unilaterally achieved better results than the others.