Middle Meningeal Artery Embolisation in Chronic Subdural Hematoma (EMMA-CS)
Prospective Multicentric Study of Middle Meningeal Artery Embolisation Combined With Surgical Treatment for Chronic Subdural Hematoma
This international multicenter study evaluates the efficacy and safety of middle meningeal artery embolization (MMAE) using PVA particles or liquid embolic agents as a perioperative treatment to prevent the recurrence of chronic subdural hematoma (cSDH). All participating patients across centers in the Czech Republic and Slovakia will receive the minimally invasive MMAE procedure within 7 days prior to or after surgical evacuation, with the primary goal of assessing hematoma recurrence rates and procedure-related complications over a 90-day follow-up period.
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:David Brustman
- 電話番号:+420723419588
- メール:david.brustman@fnhk.cz
研究連絡先のバックアップ
- 名前:Jan Raupach
- メール:jan.raupach@fnhk.cz
研究場所
-
-
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Hradec Králové、チェコ、500 05
- 募集
- University Hospital Hradec Kralove
-
コンタクト:
- Johana Krempova
- 電話番号:+420601087319
- メール:davidbrustman@gmail.com
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Liberec、チェコ
- 募集
- Hospital Liberec
-
コンタクト:
- Barbora Musilova
- 電話番号:+420485 311 111
- メール:barbora.musilova@nemlib.cz
-
コンタクト:
- Miroslav Sercl
-
Olomouc、チェコ、77909
- 募集
- University Hospital Olomouc
-
コンタクト:
- Tomas Malenak
- 電話番号:+420585 851 111
- メール:tomas.malenak@fnol.cz
-
コンタクト:
- David Krieg
- メール:david.krieg@fnol.cz
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Prague、チェコ、16902
- 募集
- The Military University Hospital Prague
-
コンタクト:
- Richard Voldrich
- 電話番号:+420973 208 333
- メール:richard.voldrich@uvn.cz
-
Prague、チェコ
- 募集
- University Hospital Motol and Homolka
-
コンタクト:
- Radek Padr
- 電話番号:+420 224 431 111
- メール:radek.padr@fnmotol.cz
-
コンタクト:
- Alena Snajdrova
- メール:alena.snajdrova@homolka.cz
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České Budějovice、チェコ
- 募集
- Hospital Ceske Budejovice
-
コンタクト:
- Roman Klus
- 電話番号:+420387 871 111
- メール:klus.roman@nemcb.cz
-
コンタクト:
- David Mestan
- メール:mestan.david@nemcb.cz
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Age 18 years or older.
- Diagnosis of a symptomatic or asymptomatic chronic or subacute subdural hematoma (cSDH) confirmed by neuroimaging (CT or MRI).
- Hematoma thickness of 5 mm or greater at its widest point on baseline neuroimaging.
- Patient is managed either conservatively or via standard surgical evacuation (e.g., burr-hole craniostomy) where MMAE is planned as a standalone or adjunctive treatment.
- Written informed consent provided by the patient or a legally authorized representative.
Exclusion Criteria:
- Acute subdural hematoma requiring emergency surgical decompression due to severe neurological deficit with signs of impending herniation.
- Evidence of an active intracranial infection or sepsis.
- Known vascular malformation, aneurysm, or dural arteriovenous fistula as the source of the hematoma.
- Severe uncorrectable coagulopathy or bleeding disorder (e.g., platelet count <50,000/µL or INR >2.0 that cannot be safely corrected before the procedure).
- Severe renal impairment (e.g., eGFR <30 mL/min/1.73m²) or known severe allergy to iodinated contrast media (unless adequate premedication is possible).
- Life expectancy of less than 3 months due to severe comorbid conditions.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:防止
- 割り当て:非ランダム化
- 介入モデル:階乗代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Intervention Arm
Patients with chronic subdural hematoma (cSDH) who undergo middle meningeal artery embolization (MMAE). This procedure is performed either as a standalone treatment or as an adjunct to surgical evacuation, based on clinical indication. |
Endovascular occlusion of the middle meningeal artery (MMA) performed under fluoroscopic guidance. The procedure aims to devascularize the chronic subdural hematoma membrane to promote hematoma resorption and prevent recurrence. |
|
介入なし:Standard Care Arm
Patients with chronic subdural hematoma (cSDH) who receive standard clinical care without undergoing middle meningeal artery embolization. This includes standard surgical evacuation (burr-hole craniostomy) or conservative management (observation, medication) based on current guidelines. |
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Rate of hematoma recurrence or treatment failure requiring surgical evacuation
時間枠:Up to 90 days post-enrollment.
|
The proportion of participants who experience a symptomatic or radiologically confirmed recurrence or progression of chronic subdural hematoma (cSDH) in the target hemisphere that requires surgical intervention (or re-operation for surgically treated patients) within the follow-up period. |
Up to 90 days post-enrollment.
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Incidence of periprocedural and postprocedural complications
時間枠:During hospitalization, up to 7 days post-procedure
|
Safety outcomes evaluating complications related to the middle meningeal artery embolisation (MMAE) procedure or the embolic material. This includes technical failure, ischemic stroke, new intracranial hemorrhage, facial nerve palsy, visual impairment, local arterial access site complications (e.g., hematoma, pseudoaneurysm), or severe allergic reactions to contrast media. |
During hospitalization, up to 7 days post-procedure
|
協力者と研究者
出版物と役立つリンク
一般刊行物
- Siddiq F, Shakir M, Nguyen TN, Hassan AE, Abdalkader M, Kenmuir CL, Liebeskind DS, Novakovic R, Majidi S, Sheth SA, El-Ghanem M, Ortega-Gutierrez S, Guerrero WR, Malik AM. Consensus Statement on Middle Meningeal Artery Embolization in Chronic Subdural Hematoma Treatment: A Guideline from the Society of Vascular and Interventional Neurology Guidelines and Practice Standards Committee. Stroke Vasc Interv Neurol. 2025 Sep 15;5(6):e001814. doi: 10.1161/SVIN.125.001814. eCollection 2025 Nov.
- Mascitelli JR, Bulsara KR, Marden FA, Raper DMS, Tenser MS, Al Saiegh F, Waldau B, Hetts SW, Schirmer CM. Current state of the field and recommendations for middle meningeal artery embolization in chronic subdural hematoma: A Report of the SNIS Standards and Guidelines Committee, Endorsed by ANZSNR and ESMINT. J Neurointerv Surg. 2026 Apr 29:jnis-2026-024979. doi: 10.1136/jnis-2026-024979. Online ahead of print.
- Maresca G, Ottaviani M, Ryan KM, Brutti S, Appetecchi GB. Improved Compatibility of alpha-NaMnO2 Cathodes at the Interface with Ionic Liquid Electrolytes. ChemSusChem. 2024 Nov 11;17(21):e202400514. doi: 10.1002/cssc.202400514. Epub 2024 Jun 10.
- Brunet-Manquat L, Combedazou A, Ahuja B, Maden A, Ramus C, Mardovina T, Frolet C. Pre-ANDA strategy and Human Factors activities to de-risk pharmaceutical companies ANDA submission of drug-device combination products: case study of a formative Comparative Use Human Factors study. Expert Opin Drug Deliv. 2024 May;21(5):767-778. doi: 10.1080/17425247.2024.2356678. Epub 2024 May 29.
- Peng MY, Zhang X, Li QD, Feng EM, Chen L, Yang HC, Guo B, Di YT, Tang L, Luo RC, Yan Y. Two new jatrophane diterpenoids from Euphorbia helioscopia with activity towards autophagic flux. J Asian Nat Prod Res. 2024 Aug;26(8):900-909. doi: 10.1080/10286020.2024.2345181. Epub 2024 May 16.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- FN HK
- Internal academic grant (その他の識別子:University Hospital Hradec Kralove, Czech Republic)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
De-identified individual participant data (IPD) including baseline demographics, clinical characteristics, neuroimaging metrics (hematoma thickness and volume), procedural details of middle meningeal artery embolisation, and follow-up clinical and radiological outcomes will be shared. Only data that underlie the results reported in the final published article will be made available.
IPD 共有時間枠
Data will become available beginning 6 months after the primary publication of the study results and will remain accessible for 36 months following publication.
IPD 共有アクセス基準
Anonymized data will be shared with qualified academic researchers upon reasonable request. Requests must include a scientifically sound research proposal and a statistical analysis plan. Proposals will be reviewed and approved by the principal investigators of the study. Data will be shared strictly for the purpose of meta-analysis or independent verification of the results via secure data transfer.
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。