The Rise and Fall of Interventional Pulmonology Procedures: Lessons in Innovation, Evidence, and Abandonment

Interventional pulmonology has produced numerous bronchoscopic and pleural procedures that were widely adopted but later declined or abandoned. This review examines selected techniques across diagnostic and therapeutic domains, focusing on their clinical Confirmed performance and reasons for attrition. Common drivers of decline include limited incremental benefit, high operator dependence, technological complexity, and competition from more effective alternatives. In several cases, early observational success was not sustained in randomized or real-world settings. Understanding why procedures fail is essential to guide the development, evaluation, and adoption of future technologies in interventional pulmonology.