Collateral Ventilation Effects on Response to AeriSeal System Treatment in Upper Lobe Predominant Emphysema

Inclusion Criteria: * Willing and able to provide informed consent and to participate in the study * Age \> or = 40 years at the time of the screening * Advanced upper lobe predominant emphysema by CT scan * Two (2) subsegments appropriate for treatment based upon CT scan in 2 different upper lobe segments in each lung (total 4 available subsegments) * MRCD questionnaire score of 2 or greater at screening * Failure of medical therapy to provide relief of symptoms * Spirometry 15 minutes after administration of bronchodilator (BOTH): * FEV1 \< 50% predicted * FEV1/FVC ratio \< 70% * Lung volumes by plethysmography (BOTH): * TLC \> 100% predicted * RV \> 150% predicted * DLco \> or = 20 and \< or = 60% predicted * Oxygen saturation (SpO2) \> 90% on \< or = 4 L/min supplemental O2, at rest * Six-Minute Walk Test distance \> or = 150 m * Abstinence from smoking for at least 16 weeks prior to screening Exclusion Criteria: * Prior lung volume reduction surgery, prior lobectomy or pneumonectomy, prior lung transplantation, prior airway stent placement, prior pleurodesis, or prior endobronchial lung volume reduction therapy of any type * Requirement for ventilator support (invasive or non-invasive) * Three (3) or more COPD exacerbations requiring hospitalization within 1 year of Screening visit or a COPD exacerbation requiring hospitalization within 8 weeks of Screening visit * α-1 antitrypsin serum level of \<80 mg/dl (immunodiffusion) or \<11µmol/L (nephelometry) at Sc…