debris and necrotic tissue. Where there is tumour ingress extrinsically or loss of the airway structure, endobronchial stents may be considered. These primarily have a role in supporting the trachea or main bronchi. Stents are available in a variety of forms, from SEMS (which may be bare, partly or fully covered) to silicon stents. Bronchoscopic lung volume reduction using endobronchial valves has been established as part of optimal medical treatment, as a treatment for severe hyperinflation and for use in the absence of collateral ventilation. Alternative approaches that are being developed include endobronchial coils, vapour therapy (which uses the fibrotic effects of thermal ablation) and chemical fibrotic agents. In COPD, ablation of the vagus nerve using radio frequency ablation of the nerve plexus surrounding the main bronchi is at an advanced phase of development. Cryospray therapy with liquid nitrogen is also in development for the treatment of chronic bronchitis. Bronchial thermoplasty has been shown to be effective in a wide group of asthma patients and has been available for about 10 years. Bronchoscopy has evolved from a simple visual tool that relies on light, to an imaging tool with integrated ultrasound that allows sampling of parabronchial and mediastinal abnormalities. Its true potential is the increasing number of conditions that may be treated using a bronchoscopic approach. Disclosures: F.J.F. Herth has received personal fees from the following, outside the submitted work: Olympus, Pulmonx, BTG, Uptake, Broncus, BSI and Erbe. P.L. Shah has received personal fees from the following, outside the submitted work: Olympus, PneumRX/BTG, Broncus, Medtronic, Creo Medical and Holairia. On behalf of Imperial College, P.L. Shah has also received sponsorship from the following for a bronchoscopy course: ERBE, Cook Medical, Medtronic, Boston Scientific, Aquilant, Broncus, Pulmonx, Olympus and PneumRX. D. Gompelmann reports receiving personal fees, outside the submitted work, from the following: PulmonX, Olympus, Chiesi, Novartis, Boehringer Ingelheim, Berlin Chemie, AstraZeneca and Mundipharma. xiii
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