TY - JOUR T1 - Randomised trial of first-line bronchial artery embolisation for non-severe haemoptysis of mild abundance JF - BMJ Open Respiratory Research JO - BMJ Open Resp Res DO - 10.1136/bmjresp-2021-000949 VL - 8 IS - 1 SP - e000949 AU - Muriel Fartoukh AU - Alexandre Demoule AU - Olivier Sanchez AU - Sophie Tuffet AU - Emmanuel Bergot AU - Cendrine Godet AU - Claire Andrejak AU - Sandrine Pontier-Marchandise AU - Antoine Parrot AU - Julien Mayaux AU - Guy Meyer AU - Philippe Cluzel AU - Marc Sapoval AU - Vincent Le Pennec AU - Marie-France Carette AU - Jacques Cadranel AU - Alexandra Rousseau AU - Antoine Khalil AU - Tabassome Simon A2 - , Y1 - 2021/06/01 UR - http://bmjopenrespres.bmj.com/content/8/1/e000949.abstract N2 - Background Whereas first-line bronchial artery embolisation (BAE) is considered standard of care for the management of severe haemoptysis, it is unknown whether this approach is warranted for non-severe haemoptysis.Research question To assess the efficacy on bleeding control and the safety of first-line BAE in non-severe haemoptysis of mild abundance.Study design and methods This multicentre, randomised controlled open-label trial enrolled adult patients without major comorbid condition and having mild haemoptysis (onset <72 hours, 100–200 mL estimated bleeding amount), related to a systemic arterial mechanism. Patients were randomly assigned (1:1) to BAE associated with medical therapy or to medical therapy alone.Results Bleeding recurrence at day 30 after randomisation (primary outcome) occurred in 4 (11.8%) of 34 patients in the BAE strategy and 17 (44.7%) of 38 patients in the medical strategy (difference −33%; 95% CI −13.8% to −52.1%, p=0.002). The 90-day bleeding recurrence-free survival rates were 91.2% (95% CI 75.1% to 97.1%) and 60.2% (95% CI 42.9% to 73.8%), respectively (HR=0.19, 95% CI 0.05 to 0.67, p=0.01). No death occurred during follow-up and no bleeding recurrence needed surgery.Four adverse events (one major with systemic emboli) occurred during hospitalisation, all in the BAE strategy (11.8% vs 0%; difference 11.8%, 95% CI 0.9 to 22.6, p=0.045); all eventually resolved.Conclusion In non-severe haemoptysis of mild abundance, BAE associated with medical therapy had a superior efficacy for preventing bleeding recurrences at 30 and 90 days, as compared with medical therapy alone. However, it was associated with a higher rate of adverse events.Trial registration number NCT01278199Data are available upon reasonable request. Consultation by the editorial board or interested researchers may be considered, subject to prior determination of the terms and conditions of such consultation and with respect to compliance with the applicable regulations. ER -