Middle Meningeal Artery (MMA) Embolization Compared to Traditional Surgical Strategies to Treat Chronic Subdural Hematomas (cSDH)

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-06-19

Study Completion Date

2022-04-19

Brief Summary

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Chronic Subdural Hematoma (cSDH) is a common hematologic problem particularly in older patients. The purpose of this study is to evaluate the safety and efficacy of middle meningeal artery (MMA) embolization compared to traditional surgical strategies for patients presenting with chronic subdural hematoma (cSDH). Although MMA embolization is minimally-invasive procedure that is routinely used for the treatment of tumors or vascular formations (1), this study investigates the use of an established procedure for a new disease state.

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Detailed Description

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The purpose of the research study is to evaluate the safety and efficacy of a new, less-invasive procedure to treat chronic subdural hematoma (cSDH). A subdural hematoma occurs when blood collects on the brain's surface beneath the skull. Subdural hematomas can be life-threatening. They usually result from a head injury. This study will compare the new procedure to conventional surgical treatment of chronic subdural hematoma (cSDH). The new procedure is called middle meningeal artery embolization (MMA).

Current or conventional treatment of chronic subdural hematoma (cSDH) involves surgery (burr hole drainage and craniotomy) to access and remove the cause of the bleeding that is causing the subdural hematoma.

The new procedure, MMA embolization, involves guiding a catheter that is inserted into a blood vessel to the area of the brain that is supplying blood to the subdural hematoma. Particles or a special type of glue will be released to stop the bleeding that is causing the subdural hematoma. This technique has been used to treat other brain conditions, for example, (to treat tumors or malformation of blood vessels).

Conditions

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Chronic Subdural Hematoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Middle Meningeal Artery Embolization

Group Type EXPERIMENTAL

Middle Meningeal Artery procedure

Intervention Type PROCEDURE

Seal off the blood supply to the middle meningeal artery to prevent growth of the Subdural Hematoma

Traditional Surgery

Craniotomy/Burr hole

Group Type ACTIVE_COMPARATOR

Traditional Surgery

Intervention Type PROCEDURE

Drainage of Subdural Hematoma using Craniotomy or Burr Hole

Interventions

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Middle Meningeal Artery procedure

Seal off the blood supply to the middle meningeal artery to prevent growth of the Subdural Hematoma

Intervention Type PROCEDURE

Traditional Surgery

Drainage of Subdural Hematoma using Craniotomy or Burr Hole

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18 or older
* Participant or Surrogate must be English speaking
* Subjects must have a diagnosis of chronic or acute-on subdural hematoma based on brain imaging, as documented by an
* One or more symptoms attributable to chronic SDH including headache cognitive impairment, gait instability, seizure, or mild focal neurologic deficit.
* In opinion of Investigator or the subject's referring physician, the subject has failed conservative management.

Exclusion Criteria

* The Subdural hematoma is causing mass effect significant enough to cause marked or progressive neurologic impairment
* Any requirement for urgent surgical evacuation is necessary
* Life expectancy is less than 6 months in the opinion of the subject's primary physician
* Markedly tortuous vasculature precluding safe endovascular access, as assessed on angiogram
* Acute subdural hematomas
* Health insurance doesn't cover MMA embolization or performing Surgeon and follow up visits are considered out of network.
* Pregnancy

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No