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- Klinische proef NCT07751887
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.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: David Brustman
- Telefoonnummer: +420723419588
- E-mail: david.brustman@fnhk.cz
Studie Contact Back-up
- Naam: Jan Raupach
- E-mail: jan.raupach@fnhk.cz
Studie Locaties
-
-
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Hradec Králové, Tsjechië, 500 05
- Werving
- University Hospital Hradec Kralove
-
Contact:
- Johana Krempova
- Telefoonnummer: +420601087319
- E-mail: davidbrustman@gmail.com
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Liberec, Tsjechië
- Werving
- Hospital Liberec
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Contact:
- Barbora Musilova
- Telefoonnummer: +420485 311 111
- E-mail: barbora.musilova@nemlib.cz
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Contact:
- Miroslav Sercl
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Olomouc, Tsjechië, 77909
- Werving
- University Hospital Olomouc
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Contact:
- Tomas Malenak
- Telefoonnummer: +420585 851 111
- E-mail: tomas.malenak@fnol.cz
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Contact:
- David Krieg
- E-mail: david.krieg@fnol.cz
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Prague, Tsjechië, 16902
- Werving
- The Military University Hospital Prague
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Contact:
- Richard Voldrich
- Telefoonnummer: +420973 208 333
- E-mail: richard.voldrich@uvn.cz
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Prague, Tsjechië
- Werving
- University Hospital Motol and Homolka
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Contact:
- Radek Padr
- Telefoonnummer: +420 224 431 111
- E-mail: radek.padr@fnmotol.cz
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Contact:
- Alena Snajdrova
- E-mail: alena.snajdrova@homolka.cz
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České Budějovice, Tsjechië
- Werving
- Hospital Ceske Budejovice
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Contact:
- Roman Klus
- Telefoonnummer: +420387 871 111
- E-mail: klus.roman@nemcb.cz
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Contact:
- David Mestan
- E-mail: mestan.david@nemcb.cz
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Faculteitstoewijzing
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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. |
|
Geen tussenkomst: 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. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Rate of hematoma recurrence or treatment failure requiring surgical evacuation
Tijdsspanne: 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.
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Incidence of periprocedural and postprocedural complications
Tijdsspanne: 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
|
Medewerkers en onderzoekers
Publicaties en nuttige links
Algemene publicaties
- 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.
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Cerebrovasculaire aandoeningen
- Hersenziekten
- Ziekten van het centrale zenuwstelsel
- Ziekten van het zenuwstelsel
- Vaatziekten
- Hart-en vaatziekten
- Wonden en verwondingen
- Pathologische processen
- Chronische ziekte
- Ziekte attributen
- Bloeding
- Craniocerebraal trauma
- Trauma, zenuwstelsel
- Intracraniële bloedingen
- Intracraniële bloeding, traumatisch
- Pathologische aandoeningen, tekenen en symptomen
- Hematoom, subduraal
- Hematoom
- Herhaling
- Hematoom, subduraal, chronisch
Andere studie-ID-nummers
- FN HK
- Internal academic grant (Andere identificatie: University Hospital Hradec Kralove, Czech Republic)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
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-tijdsbestek voor delen
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-toegangscriteria voor delen
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 delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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