NCT04402632

Brief Summary

The purpose of this study is to evaluate the safety and efficacy of embolization of the middle meningeal artery (MMA) using the Onyx™ Liquid Embolic System (LES) for treatment of symptomatic subacute or chronic subdural hematoma (SDH)

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
600

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Oct 2020

Longer than P75 for not_applicable

Geographic Reach
1 country

49 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 18, 2020

Completed
9 days until next milestone

First Posted

Study publicly available on registry

May 27, 2020

Completed
5 months until next milestone

Study Start

First participant enrolled

October 27, 2020

Completed
4.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 19, 2024

Completed
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

April 3, 2025

Completed
Last Updated

December 11, 2025

Status Verified

December 1, 2025

Enrollment Period

4.1 years

First QC Date

May 18, 2020

Last Update Submit

December 9, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Rate of hematoma recurrence/progression requiring surgical drainage OR poor clinical outcome at 90 days, OR clinical deterioration at 90 days compared to baseline

    90 days post-procedure

Secondary Outcomes (9)

  • Non-inferiority assessment of Onyx™ LES embolization treatment compared to standard of care based on change in Modified Rankin Scale Score

    90 days post-procedure

  • Effectiveness: Incidence of hospital readmissions

    90 days post-procedure

  • Effectiveness: Change in hematoma volume based on CT/MRI imaging

    90 days post-procedure

  • Effectiveness: Change in hematoma thickness per CT/MRI imaging

    90 days post-procedure

  • Effectiveness: Change in midline shift based on CT/MRI imaging

    90 days post-procedure

  • +4 more secondary outcomes

Study Arms (4)

Surgery Cohort: Control Arm

ACTIVE COMPARATOR
Procedure: Surgical Management

Surgery Cohort: Treatment Arm

EXPERIMENTAL
Device: Onyx™ Liquid Embolic System (LES) EmbolizationProcedure: Surgical Management

Observational Cohort: Control Arm

ACTIVE COMPARATOR
Other: Observation Only

Observational Cohort: Treatment Arm

EXPERIMENTAL
Device: Onyx™ Liquid Embolic System (LES) Embolization

Interventions

Medical Management (Control)

Observational Cohort: Control Arm

Onyx™ LES Embolization of the Subdural Hematoma (SDH)

Surgery Cohort: Treatment Arm

Surgical Evacuation of the Subdural Hematoma (SDH) (Control)

Surgery Cohort: Control Arm

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Pre-morbid Modified Rankin Score ≤3
  • Confirmed diagnosis of subacute or chronic subdural hematoma
  • Completed informed consent
  • Meets criteria for Surgery or Observation Cohort

You may not qualify if:

  • Life expectancy \<1 year
  • Unable to complete follow-up
  • Pregnant, lactating, or has a positive pregnancy test at time of admission
  • Diagnosed with acute SDH
  • Potentially dangerous anatomic variations leading to increased procedural risk or unsafe access for MMA embolization
  • Pre-randomized Markwalder Grading Scale score ≥ 3
  • Unmanaged, uncontrolled bleeding disorders/blood diathesis
  • Presumed septic embolus, or suspicion of microbial superinfection
  • Known active COVID-19 infection
  • CT or MRI evidence of intra-cranial tumor or mass lesion Contraindication to angiography
  • Participation in another clinical trial
  • Contraindicated for the use of Onyx™ LES
  • Cannot be taken off corticosteroids (intended to treat subacute or chronic SDH) for at least 90 days post-randomization

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (49)

University of Alabama at Birmingham (UAB) Hospital

Birmingham, Alabama, 35233-1932, United States

Location

Carondelet St. Joseph's Hospital

Tucson, Arizona, 85710, United States

Location

University of California Irvine Medical Center

Irvine, California, 92868, United States

Location

USC - Keck School of Medicine

Los Angeles, California, 90033, United States

Location

Huntington Memorial Hospital

Pasadena, California, 91105, United States

Location

UCSD Medical Center

San Diego, California, 92037, United States

Location

California Pacific Medical Center

San Francisco, California, 94109, United States

Location

University of California San Francisco Medical Center

San Francisco, California, 94143, United States

Location

Providence Little Company of Mary Medical Center

Torrance, California, 90503-4607, United States

Location

University of Colorado Denver School of Medicine

Aurora, Colorado, 80045, United States

Location

UF Health Heart and Vascular Hospital

Gainesville, Florida, 32608, United States

Location

Memorial Regional Hospital

Hollywood, Florida, 33021, United States

Location

Baptist Medical Center Jacksonville

Jacksonville, Florida, 322047, United States

Location

Jackson Memorial Hospital

Miami, Florida, 33136, United States

Location

Orlando Regional Medical Center Orlando Health

Orlando, Florida, 32806, United States

Location

Tampa General Hospital

Tampa, Florida, 33606, United States

Location

Saint Mary's Medical Center

West Palm Beach, Florida, 33407, United States

Location

Grady Memorial Hospital

Atlanta, Georgia, 30303, United States

Location

Rush University Medical Center

Chicago, Illinois, 60612, United States

Location

Advocate Lutheran General Hospital

Park Ridge, Illinois, 60068, United States

Location

Ascension Saint Vincent Hospital

Indianapolis, Indiana, 46260, United States

Location

University of Iowa Hospitals and Clinics

Iowa City, Iowa, 52242, United States

Location

University of Kentucky Albert B Chandler Hospital

Lexington, Kentucky, 40506, United States

Location

Brigham and Women's Hospital

Boston, Massachusetts, 02115, United States

Location

Lahey Hospital & Medical Center

Burlington, Massachusetts, 01805-0001, United States

Location

McLaren Flint Hospital

Flint, Michigan, 48532, United States

Location

Corewell Health

Grand Rapids, Michigan, 49503, United States

Location

Barnes-Jewish Hospital

St Louis, Missouri, 63110, United States

Location

Albany Medical Center

Albany, New York, 12208, United States

Location

Buffalo General Medical Center

Buffalo, New York, 14203, United States

Location

North Shore University Hospital

Manhasset, New York, 11030, United States

Location

The Mount Sinai Hospital

New York, New York, 10029, United States

Location

New York-Presbyterian Hospital/Weill Cornell Medical Center

New York, New York, 10065, United States

Location

Westchester Medical Center

Valhalla, New York, 10595, United States

Location

Atrium Health's Carolinas Medical Center

Charlotte, North Carolina, 28204, United States

Location

Cleveland Clinic

Cleveland, Ohio, 44195-0001, United States

Location

The Ohio State University/Wexner Medical Center

Columbus, Ohio, 43210, United States

Location

ProMedica Toledo Hospital

Toledo, Ohio, 43606, United States

Location

Oklahoma University Medical Center

Oklahoma City, Oklahoma, 73104, United States

Location

Oregon Health & Science University Hospital

Portland, Oregon, 97239-3011, United States

Location

Geisinger Medical Center

Danville, Pennsylvania, 17822, United States

Location

University of Pittsburgh Medical Center UPMC Presbyterian

Pittsburgh, Pennsylvania, 15213-2536, United States

Location

Prisma Health

Greenville, South Carolina, 29605, United States

Location

Valley Baptist Medical Center

Harlingen, Texas, 78550, United States

Location

Memorial Hermann-Texas Medical Center

Houston, Texas, 77030, United States

Location

Baylor Scott & White Medical Center - Temple

Temple, Texas, 76508-0001, United States

Location

University of Utah Hospital

Salt Lake City, Utah, 84132, United States

Location

Harborview Medical Center

Seattle, Washington, 98104-2420, United States

Location

Aurora Saint Luke's Medical Center

Milwaukee, Wisconsin, 53215, United States

Location

Related Publications (2)

  • Kniep H, Gellissen S, Bechstein M, Meyer L, Broocks G, Heitkamp C, Winkelmeier L, Flottmann F, Geest V, Hanning U, Thaler C, Bester M, Davies JM, Knopman J, Mokin M, Hassan AE, Harbaugh RE, Khalessi A, Siddiqui AH, Gross BA, Grandhi R, Tarpley J, Sivakumar W, Bain M, Crowley RW, Link TW, Fraser JF, Levitt MR, Chen PR, Hanel RA, Bernard JD, Jumaa M, Youssef P, Cress MC, Chaudry MI, Shakir HJ, Lesley WS, Billingsley J, Jones J, Koch MJ, Paul AR, Mack WJ, Osbun JW, Dlouhy K, Grossberg JA, Kellner CP, Sahlein DH, Santarelli J, Schirmer CM, Singer J, Liu JJ, Majjhoo AQ, Wolfe T, Patel NV, Roark C, Fiehler J; EMBOLISE Investigators. Middle Meningeal Artery Embolization for Subdural Hematoma: CT/MRI End Points of the EMBOLISE Trial. Radiology. 2026 Jan;318(1):e251746. doi: 10.1148/radiol.251746.

  • Davies JM, Knopman J, Mokin M, Hassan AE, Harbaugh RE, Khalessi A, Fiehler J, Gross BA, Grandhi R, Tarpley J, Sivakumar W, Bain M, Crowley RW, Link TW, Fraser JF, Levitt MR, Chen PR, Hanel RA, Bernard JD, Jumaa M, Youssef P, Cress MC, Chaudry MI, Shakir HJ, Lesley WS, Billingsley J, Jones J, Koch MJ, Paul AR, Mack WJ, Osbun JW, Dlouhy K, Grossberg JA, Kellner CP, Sahlein DH, Santarelli J, Schirmer CM, Singer J, Liu JJ, Majjhoo AQ, Wolfe T, Patel NV, Roark C, Siddiqui AH; EMBOLISE Investigators. Adjunctive Middle Meningeal Artery Embolization for Subdural Hematoma. N Engl J Med. 2024 Nov 21;391(20):1890-1900. doi: 10.1056/NEJMoa2313472.

MeSH Terms

Conditions

Hematoma, Subdural

Interventions

Embolization, Therapeutic

Condition Hierarchy (Ancestors)

Intracranial Hemorrhage, TraumaticIntracranial HemorrhagesCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesCraniocerebral TraumaTrauma, Nervous SystemVascular DiseasesCardiovascular DiseasesHematomaHemorrhagePathologic ProcessesPathological Conditions, Signs and SymptomsWounds and Injuries

Intervention Hierarchy (Ancestors)

Hemostatic TechniquesTherapeuticsTherapeutic Occlusion

Study Officials

  • Jared Knopman, MD

    New York-Presbyterian Hospital/Weill Cornell Medical Center

    PRINCIPAL INVESTIGATOR
  • Jason Davies, MD

    Buffalo General Medical Center

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
SEQUENTIAL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 18, 2020

First Posted

May 27, 2020

Study Start

October 27, 2020

Primary Completion

December 19, 2024

Study Completion

April 3, 2025

Last Updated

December 11, 2025

Record last verified: 2025-12

Data Sharing

IPD Sharing
Will not share

No individual participant data will be available

Locations