BENTO - Bronchoscopic Lung Volume Reduction in Severe Emphysema Using Thermoablation

This study is testing a bronchoscopic procedure called thermal vapor ablation (BTVA) to reduce lung volume in people with severe emphysema (a form of advanced COPD). The treatment targets over-inflated areas of the upper lungs using steam delivered through a bronchoscope (a thin tube passed through the airways), without open surgery. **You may be eligible if...** - You are between 40 and 75 years old with severe emphysema, mainly in the upper lobes - Your lung function tests confirm severe hyperinflation and reduced breathing capacity - You have not smoked for at least 6 months - You have already completed pulmonary rehabilitation - You are significantly short of breath even with optimal medical treatment **You may NOT be eligible if...** - Your lung diffusion capacity (DLCO) is severely reduced (below 20%) - Your BMI is below 18 or above 32 - You have pulmonary hypertension or other significant lung or heart conditions - You have another major condition that would interfere with recovery Talk to your doctor to see if this trial is right for you.