The study hypothesis is that patients with homogeneous emphysema behave differently compared
to heterogeneous emphysema with respect to exercise capacity. A better understanding of this
difference will allow the investigators to choose the best treatment for each type of
The main purpose of this study is to evaluate the change in exercise capacity measured by
cycle ergometry in patients with severe emphysema after endoscopic lung volume reduction with
As a secondary purpose, the investigators want to perform an exploratory, randomized study to
compare the results of two different therapeutic approaches in a small sample of patients
with homogeneous emphysema.