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NCT Number: NCT07751887

Middle Meningeal Artery Embolisation in 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.

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This study is active but is not currently recruiting participants.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Middle Meningeal Artery Embolisation

Device

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.

Primary outcomes

  1. Rate of hematoma recurrence or treatment failure requiring surgical evacuation

    Time frame: 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.

Secondary outcomes

  1. Incidence of periprocedural and postprocedural complications

    Time frame: 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.

Sponsors and collaborators

Lead sponsor

University Hospital Hradec Kralove

Other

Registry information

Official study title

Prospective Multicentric Study of Middle Meningeal Artery Embolisation Combined With Surgical Treatment for Chronic Subdural Hematoma

Acronym: EMMA-CS

Important dates

Study start
2026
Primary completion
2029
Study completion
2029
First posted
Aug 7, 2026
Registry last updated
Aug 7, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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