Patients with severe chronic obstructive pulmonary disease (COPD) suffer on a daily basis, despite important efforts to support this large patient population with pharmacotherapy. To potentially relieve symptoms, innovative bronchoscopic treatments have been developed in the past decade: the one-way endobronchial valve therapy for patients with severe emphysema and absence of interlobar collateral ventilation;1 the trans-bronchial airway bypass for severe emphysema, relying on the presence of collateral ventilation;2 nitinol coil treatment for a wide range of emphysema phenotypes independent of collateral ventilation;3 parasympathetic lung denervation for patients with COPD who respond well to anticholinergic agents;4 and sclerosing therapies such as crosslink compounds5 and steam,6 both of which target the most diseased parenchymal defects.