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Bronchial Artery Embolization and Medical Measures in Non Severe Acute Hemoptysis of Mild-moderate Abundance

Not Applicable
Completed
Conditions
Hemoptysis
Acute Disease
Interventions
Other: bronchial artery embolization
Other: Medicals measures
Registration Number
NCT01278199
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

Severe hemoptysis is a life-threatening condition, with an unpredictable course. The efficacy of bronchial artery embolization (BAE) is well established for the treatment of severe hemoptysis, with short and long-term bleeding controls obtained in 70 to 100% and 50 to 90% of cases, respectively. As complications related to vascular interventional radiology may occur in 5 to 10% of cases, the benefit-risk balance might be less clear in acute hemoptysis of mild-to-moderate abundance (volume between 100 and 200 ml) and no criteria of severity (respiratory failure or hemodynamic instability). There is no available data comparing the safety and efficacy of BAE combined with medical measures to those of medical measures alone in the treatment of non-severe acute hemoptysis of mild-to-moderate abundance.

Detailed Description

The study is a multicentric (n=8) randomized study, involving two parallel groups of patients with non-severe acute hemoptysis of mild-to-moderate abundance, related to a systemic bronchial or non-bronchial hypervascularization, and comparing the bronchial artery embolization combined with medical measures and the medical measures alone in this field.

The primary aim of the study is to evaluate the efficacy of BAE combined with medical measures in the treatment of non-severe acute hemoptysis of mild-to-moderate abundance, as compared with that of medical measures alone, by assessing the percentage of recurrence of hemoptysis at one month. Bleeding recurrence is defined as a volume of blood expectorated of at least 50 ml.

The second objectives of the study are to compare the efficacy of the two strategies at 3 months and to assess the safety of both strategies during hospitalization and follow-up.

Based on a previous study of our group (Reference 8), the number of patients in each group is 105, assuming a one-month bleeding recurrence rate of 11% in the group receiving BAE, as compared with 26% in the group assisted medically (a=.05; β=0.8).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
73
Inclusion Criteria
  • Non-severe acute hemoptysis (mild-to-moderate abundance and no criteria of severity).
  • Age > 18 years
  • Patients with social insurance
Exclusion Criteria
  • Pregnant and/or lactating women
  • Traumatic hemoptysis
  • Severe hemoptysis (volume > 200 ml; respiratory failure; hemodynamic instability)
  • Patients already enrolled in the study within the preceding 3 months
  • Patients in palliative care, for whom there is no therapeutic plan at short-term
  • Moribund patients

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1bronchial artery embolizationbronchial artery embolization (BAE)
2Medicals measuresMedicals measures in the treatment of non-severe acute hemoptysis
Primary Outcome Measures
NameTimeMethod
Bleeding recurrence rate, after initial therapeutic strategy.One month

Bleeding recurrence is defined as a volume of expectorated blood of 50 ml or more.

Secondary Outcome Measures
NameTimeMethod
Evaluation of the rate of serious adverse events3 months

Evaluation of the rate of serious adverse events, according to the therapeutic strategy during hospitalization and follow-up period

Trial Locations

Locations (1)

Tenon Hospital, AP-HP

🇫🇷

Paris, France

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