Chronic obstructive pulmonary disease is, of 2024, one of the three main causes of death in the world, affecting around 12% of the world's population. Its incidence is estimated to increase in the coming decades due to continuous exposure to risk factors and to an aging population. Pulmonary emphysema is one of its most serious phenotypes, with chronic and inexorable progression and, in the most severe stages, it is highly disabling and lethal. This book reviews knowledge about the pathophysiology of severe pulmonary emphysema and the current innovative interventional and minimally invasive therapeutic concepts for the management of these advanced stages of emphysema, based on the best scientific evidence. This guide provides to multidisciplinary pulmonary boards of experts in advanced lung diseases, current criteria for the choice of precision therapeutic options and beyond to maintaining optimized medical treatment to controlling lung hyperinflation, and alleviating patients' symptoms. This book is a valuable resource for clinicians dealing with critically ill patients with COPD.