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Increasing morbidity and mortality of chronic obstructive pulmonary disease (COPD) worldwide leads to the necessity to optimize diagnostic and therapeutic options for patients with advanced lung emphysema 1. Lung emphysema is a severe debilitating form of COPD, characterized by severe dyspnea due to hyperinflation. Endoscopic lung volume reduction therapy with one-way valves (ELVR) is an important treatment that improves breathing mechanics 2–5. Treatment success highly depends on careful assessment of collateral ventilation (CV) of the target lobe prior to ELVR 4 as the absence of collateral ventilation in the target lobe is a prerequisite. The Chartis® Pulmonary Assessment System (Chartis, Pulmonx Corporation, Redwood City, CA, USA) is integral to determine presence or absence of CV. During Chartis assessment the expiratory airflow and inspiratory pressure is measured via a catheter with a balloon at the distal tip. The balloon is used to temporarily occlude the lobar bronchus 6. Results are visually characterized into four Chartis phenotypes; CV negative (CV), CV positive (CV+), low flow (LF), and low plateau (LP) 7. Footnotes This manuscript has recently been accepted for publication in the ERJ Open Research . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article. Conflict of interest: Shaida Biglari reports support for the present manuscript from Pulmonx Corp, manufacturer of the Chartis system. The author also reports to be an employee of Pulmonx Corp. Conflict of interest: Narinder S. Shargill, reports support for the present manuscript from Pulmonx Corp, manufacturer of the Chartis system. Stock options and stock grants from Pulmonx Corporation. The author also reports to be an employee of Pulmonx Corp. Conflict of interest: Martin Witzenrath reports grants and personal fees from Biotest, grants and personal fees from Pantherna, personal fees from Aptarion, personal fees from Astra Zeneca, personal fees from Chiesi, personal fees from Insmed, personal fees from Gilead, personal fees from Pfizer, personal fees from Boehringer, outside the submitted work. Conflict of interest: Sri Radhakrishnan reports support for the present manuscript from Pulmonx Corp, manufacturer of the Chartis system. The author also reports to be an employee of Pulmonx Corp. Conflict of interest: Ralf Hübner reports support for the present manuscript from Pulmonx Corp, manufacturer of the Chartis system. The author also reports to be an employee of Pulmonx Corp. Conflict of interest: The remaining authors have nothing to disclose.
Saccomanno et al. (Thu,) studied this question.