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This study evaluated the clinical implementation of bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBV) for patients with advanced emphysema and COPD at a university hospital in Sweden. Between 2022 and 2025, a total of 116 patients were evaluated, of whom 32 were treated. BLVR with EBV significantly improved lung function (FEV1), exercise capacity (6-MWT), and symptom burden (CAT score), with mean improvements exceeding the minimal clinically important difference. 3 patients (11 %) experienced complications (2 with pneumothorax, 7 %; 1 with COPD exacerbation, 4%). A dedicated multidisciplinary team with expertise in COPD, bronchoscopic interventions, and thoracic radiology is essential for treatment success. This study highlights BLVR as a promising treatment option in Sweden, with a potential for broader implementation.