Middle Meningeal Artery Embolization in Patients With Chronic Subdural Hematoma

NCT07806552 | Not Yet Recruiting

• 1 other identifier: MMAE in CSDH
• Study Type: interventional
• Target: 35
• Locations: 0 countries
• Sites: N/A

Brief Summary

Primary : to evaluate the efficacy of MMAE on resolution and recurrence of hematoma in patients with CSDH. Secondary : evaluate the effect of MMAE on functional outcome, radiological changes, the need to repeat surgery, duration of hospital stay, time for hematoma to resolve.

Conditions

Middle Meningeal Artery Embolization; Chronic Subdural Hematomas

Outcome Measures

Primary Outcomes (1)

• Recurrence Requiring Additional Surgical Intervention

  Composite outcome defined as recurrence of chronic subdural hematoma requiring repeat surgical intervention within 6 months. Recurrence may be identified by radiological enlargement or reaccumulation of the hematoma on CT associated with recurrent or worsening neurological symptoms leading to reoperation.

  six months

Study Arms (1)

Embolization of middle meningeal artery

EXPERIMENTAL

Procedure: middle meningeal artery embolization

Interventions

middle meningeal artery embolization PROCEDURE

Middle meningeal artery (MMA) embolization is a minimally invasive endovascular procedure designed to treat chronic subdural hematomas by blocking blood flow to the MMA, preventing recurrent bleeding. Under local or general anesthesia, a catheter is inserted through a micro-puncture in the femoral or radial artery and navigated up to the external carotid system into the MMA under real-time fluoroscopic (X-ray) guidance. Angiography is performed to map the arterial anatomy and identify any dangerous anastomoses with the ophthalmic or internal carotid arteries. Once positioned safely, an embolic agent such as liquid embolic systems (e.g., Onyx, n-BCA), liquid-suspended microparticles (PVA), or microcoils is injected into the anterior and posterior branches of the MMA. This occludes the fragile, hypervascular membranes driving the hematoma, allowing the body to naturally reabsorb the collected blood and reducing the need for open surgical evacuation.

Embolization of middle meningeal artery

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Any age.
• Radiologically confirmed chronic subdural hematoma (CSDH) on CT or MRI either Unilateral or Bilateral CSDH.
• Patients considered suitable for standard surgical treatment of CSDH.
• First presentation or recurrent CSDH requiring treatment.

You may not qualify if:

• Acute subdural hematoma or acute-on-chronic SDH where the acute component is the primary pathology.
• Acute and severe neurological deterioration.
• Subdural hematomas secondary to:
• Intracranial tumors.
• Intracranial infections.
• Contraindications to angiography or embolization (for the MMAE group), such as:
• Severe contrast allergy.
• Untreatable coagulopathy.
• Severe renal failure precluding contrast administration
• Severe tortuosity or anatomical variations of the external carotid artery/MMA making catheterization unfeasible.

Sponsors & Collaborators

• Assiut University: lead

Related Publications (10)

• https://doi.org/10.1016/j.clineuro.2024.108323

  BACKGROUND

• https://doi.org/10.1212/CPJ.0000000000200501

  BACKGROUND

• https://doi.org/10.1227/neu.0000000000002505

  BACKGROUND

• https://doi.org/10.20452/jmr.2025.20007

  BACKGROUND

• https://doi.org/10.1016/j.jns.2025.123469

  BACKGROUND

• https://doi.org/10.1159/000543041

  BACKGROUND

• https://doi.org/10.3389/fsurg.2025.1623619

  BACKGROUND

• https://doi.org/10.1080/01616412.2025.2592857

  BACKGROUND

• https://doi.org/10.1016/j.clineuro.2025.109128

  BACKGROUND

• Liu J, Ni W, Zuo Q, Yang H, Peng Y, Lin Z, Li Z, Wang J, Zhen Y, Luo J, Lin Y, Chen J, Hua X, Lu H, Zhong M, Liu M, Zhang J, Wang Y, Wan J, Li Y, Li T, Mao G, Zhao W, Gao L, Li C, Chen E, Cheng X, Zhang P, Wang Z, Chen L, Zhang Y, Tian B, Shen F, Lei Y, Wu Y, Li Y, Duan G, Xu L, Lv N, Yu J, Xu X, Du Z, Zhang H, Hu J, Li Z, Yuan Q, Zhou Y, Wu G, Zhang L, Gao C, Dai D, Wu X, Zhang Y, Jiang H, Zhao R, Su J, Xu Y, Ospel JM, Majoie CBLM, Goyal M, Li Q, Yang P, Gu Y, Mao Y; MAGIC-MT Investigators. Middle Meningeal Artery Embolization for Nonacute Subdural Hematoma. N Engl J Med. 2024 Nov 21;391(20):1901-1912. doi: 10.1056/NEJMoa2401201.

  PMID: 39565989 BACKGROUND

MeSH Terms

Conditions

Hematoma, Subdural, Chronic

Condition Hierarchy (Ancestors)

Hematoma, Subdural; Intracranial Hemorrhage, Traumatic; Intracranial Hemorrhages; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Craniocerebral Trauma; Trauma, Nervous System; Vascular Diseases; Cardiovascular Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Hematoma; Hemorrhage; Wounds and Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor

Study Record Dates

• First Submitted: August 30, 2026
• First Posted: September 8, 2026
• Study Start: September 1, 2026
• Primary Completion (Estimated): August 31, 2028
• Study Completion (Estimated): February 28, 2029
• Last Updated: September 8, 2026

Record last verified: 2026-09