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

NCT ID: NCT01278199

Last Updated: 2017-03-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

73 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-11-30

Study Completion Date

2017-02-27

Brief Summary

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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

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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).

Conditions

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Hemoptysis Acute Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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2

Medicals measures in the treatment of non-severe acute hemoptysis

Group Type OTHER

Medicals measures

Intervention Type OTHER

Rest in bed. Monitoring of respiratory frequency. Fixation of intravenous route. Administration of nasal oxygenotherapy in order to maintain SpO2 \> 90%. Administration of antituberculosis treatment, in case with active pulmonary tuberculosis known at admission or diagnosed during the stay.

If necessary a bronchial wash out of will be realized by a bronchial fibroscopy with measures of use of cold serum, adrenalin xylocain or terlipressin.

The administration of antibiotherapy by general mode according to the clinician appreciation.

The administration of terlipressin according to the clinician appreciation. Against the cough treatment administration according to the clinician appreciation.

1

bronchial artery embolization (BAE)

Group Type EXPERIMENTAL

bronchial artery embolization

Intervention Type OTHER

The bronchial artery embolization is practised within 48 hours which follow the hospital admission for non-severe acute hemoptysis.

Interventions

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Medicals measures

Rest in bed. Monitoring of respiratory frequency. Fixation of intravenous route. Administration of nasal oxygenotherapy in order to maintain SpO2 \> 90%. Administration of antituberculosis treatment, in case with active pulmonary tuberculosis known at admission or diagnosed during the stay.

If necessary a bronchial wash out of will be realized by a bronchial fibroscopy with measures of use of cold serum, adrenalin xylocain or terlipressin.

The administration of antibiotherapy by general mode according to the clinician appreciation.

The administration of terlipressin according to the clinician appreciation. Against the cough treatment administration according to the clinician appreciation.

Intervention Type OTHER

bronchial artery embolization

The bronchial artery embolization is practised within 48 hours which follow the hospital admission for non-severe acute hemoptysis.

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Muriel FARTOUKH, MD

Role: PRINCIPAL_INVESTIGATOR

Tenon Hospital, AP-HP

Locations

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Tenon Hospital, AP-HP

Paris, , France

Site Status

Countries

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France

References

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Other Identifiers

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K081202

Identifier Type: -

Identifier Source: org_study_id

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