Clinical Research Directory

Inclusion criteria 1. Age \< or equal 75 years 2. Stable COPD with less than or equal to 10mg prednisolone daily 3. Nonsmoking for 3 months prior to screening and willing to not smoke during the study duration 4. Willing and able to complete protocol required study follow-up assessments and procedures 5. Fit for thoracoscopy under general anaesthesia (surgical and anaesthetic assessment) 6. Recent (\< 18 months) endobronchial lung volume reduction (EBLVR) and lack of response defined by: 1. Persistent symptomatic dyspnoea (mMRC \>2) which in the patient's view is no better than baseline 2. Absence of target lobar collapse with any residual aeration apparent on imaging 3. Persistence of (6a) and (6b) following post procedure StratX CT analysis and revisional bronchoscopy. Exclusion criteria 1. Fissure completeness \<90% on pre EBLVR StratX (i.e less than 10% of fissure to be divided) 2. Chartis positive for collateral ventilation or not performed/not satisfactory at initial EBLVR 3. Quantitative perfusion of target lobe \>25% of total on SPECT assessment. 4. Previous lung surgery or pleurodesis on the target side for LVR. 5. Clinically significant bronchiectasis -greater than 4 tablespoons mucus per day. 6. More than 3 COPD exacerbation episodes in the last year. 7. Evidence of hypercapnia (pCO2 \>7KPa) - ABG to be performed on admission for index procedure 8. Clear evidence of pulmonary hypertension (systolic pulmonary arterial pressure \>45mmHg) or evidence or right ventricular dysfunction as determined by a recent echocardiogram (\<12mo) 9. Left ventricular ejection fraction (LVEF) less than 40% as determined by a recent echocardiogram (\<12mo) 10. Myocardial infarction within 6 months of screening. 11. Unable to safely discontinue anticoagulants or platelet activity inhibitors for 7 days.