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Special Features: Pulmonary Procedures |

Latest Advances in Advanced Diagnostic and Therapeutic Pulmonary ProceduresUpdate on Pulmonary Procedures

Gerard A. Silvestri, MD, FCCP; David Feller-Kopman, MD, FCCP; Alexander Chen, MD; Momen Wahidi, MD, FCCP; Kazuhiro Yasufuku, MD, PhD, FCCP; Armin Ernst, MD, MHCM, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Dr Silvestri), Medical University of South Carolina, Charleston, SC; Division of Pulmonary and Critical Care Medicine (Dr Feller-Kopman), Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine (Dr Chen), Washington University School of Medicine/Barnes-Jewish Hospital, St. Louis, MO; Division of Pulmonary and Critical Care Medicine (Dr Wahidi), Duke University, Durham, NC; Division of Thoracic Surgery (Dr Yasufuku), Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada; and Division of Pulmonary and Critical Care Medicine (Dr Ernst), Steward St. Elizabeth’s Medical Center, Tufts Medical School, Boston, MA.

Correspondence to: Gerard A. Silvestri, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, Room 812 CSB, Charleston, SC 29425; e-mail: silvestri@musc.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(6):1636-1644. doi:10.1378/chest.12-2326
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Over the past 15 years, patients with a myriad of pulmonary conditions have been diagnosed and treated with new technologies developed for the pulmonary community. Advanced diagnostic and therapeutic procedures once performed in an operating theater under general anesthesia are now routinely performed in a bronchoscopy suite under moderate sedation with clinically meaningful improvements in outcome. With the miniaturization of scopes and instruments, improvements in optics, and creative engineers, a host of new devices has become available for clinical testing and use. A growing community of pulmonologists is doing comparative effectiveness trials that test new technologies against the current standard of care. While more research is needed, it seems reasonable to provide an overview of pulmonary procedures that are in various stages of development, testing, and practice at this time. Five areas are covered: navigational bronchoscopy, endobronchial ultrasound, endoscopic lung volume reduction, bronchial thermoplasty, and pleural procedure. Appropriate training for clinicians who wish to provide these services will become an area of intense scrutiny as new skills will need to be acquired to ensure patient safety and a good clinical result.

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