Middle Meningeal Artery Embolization for Subdural Hematoma

(MEMBRANE Trial)

No longer recruiting at 33 trial locations
LM
Overseen ByLillian Ma
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Cerenovus, Part of DePuy Synthes Products, Inc.
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method for treating chronic subdural hematomas, which are persistent blood clots on the brain's surface. Researchers aim to determine if TRUFILL n-BCA embolization, combined with standard care, is more effective than standard care alone. The trial includes four groups: some will receive only standard surgery or medical care, while others will receive standard care plus the new treatment. Individuals diagnosed with chronic subdural hematoma who have not undergone previous treatment may be suitable candidates for this study. As an unphased trial, this study provides an opportunity to contribute to innovative research that could enhance future treatment options.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that TRUFILL n-BCA embolization is safe for treating chronic subdural hematomas?

Research has shown that TRUFILL n-BCA, used in middle meningeal artery embolization, is generally safe. In one study, most patients did not experience serious side effects. The treatment was usually well-tolerated, and many patients showed positive results after three months.

Additionally, a review of this treatment method found it can be safely used in adults with chronic subdural hematomas (cSDH), with few complications reported. While no treatment is completely without risk, current evidence suggests that TRUFILL n-BCA is relatively safe for those considering this option.12345

Why are researchers excited about this trial?

Researchers are excited about middle meningeal artery embolization for subdural hematoma because it offers a novel approach compared to traditional treatments like surgery and medical management. This technique involves using TRUFILL n-BCA, which is a liquid adhesive that blocks off the blood supply to the hematoma, potentially reducing its size and recurrence rates. Unlike standard surgical methods, which can be invasive, embolization is minimally invasive and could lead to quicker recovery times. Additionally, by directly targeting the blood vessels contributing to the hematoma, this method may decrease the need for repeat interventions, offering a promising alternative for patients.

What evidence suggests that TRUFILL n-BCA embolization is effective for treating chronic subdural hematomas?

Research has shown that using TRUFILL n-BCA for middle meningeal artery embolization can effectively treat chronic subdural hematomas (cSDH). In this trial, some participants will receive standard medical management or surgery alone, while others will receive standard care combined with embolization using TRUFILL n-BCA. One study found that this treatment outperforms standard care alone, leading to improved patient outcomes. The procedure involves blocking blood flow in specific brain vessels to help reduce the hematoma, a type of blood clot in the brain. Initial findings suggest that patients undergoing this treatment recover better and experience fewer complications. Experts generally agree that this method shows promise for managing cSDH.12567

Who Is on the Research Team?

Christopher P Kellner - Neurosurgery ...

Christopher Kellner, MD

Principal Investigator

MOUNT SINAI HOSPITAL

Dr. Ansaar T. Rai, MD | Morgantown, WV ...

Ansaar Rai, MD

Principal Investigator

West Virginia University

Are You a Good Fit for This Trial?

This trial is for individuals with chronic subdural hematomas who have given informed consent, have a moderate or better ability to carry out daily activities (mRS ≤ 3), and a confirmed diagnosis. It excludes those with acute hematomas, severe consciousness impairment (Glasgow Coma Scale < 9), pregnant or lactating women, anyone planning pregnancy, participants in other trials that affect results, prior treatment of the hematoma, suspected infection within the brain, evidence of brain tumor/mass lesion, severe disability due to hematoma (Markwalder assessment ≥ 3), or life expectancy less than one year.

Inclusion Criteria

Completed informed consent
I have been diagnosed with chronic subdural hematoma.
My disability level allows me to walk and take care of myself.

Exclusion Criteria

Suspected additional infection by germs.
You have a tumor or mass in your brain shown on a CT or MRI scan.
Current involvement in another clinical trial that may confound study endpoints
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive standard of care and may undergo TRUFILL n-BCA MMA embolization for the treatment of chronic subdural hematomas

Varies

Follow-up

Participants are monitored for safety and effectiveness after treatment

180 days

Long-term follow-up

Participants are monitored for health economics outcomes such as hospital days

365 days

What Are the Treatments Tested in This Trial?

Interventions

  • TRUFILL n-BCA
Trial Overview The study compares standard care alone versus standard care plus TRUFILL n-BCA embolization for treating chronic subdural hematomas. Participants are divided into groups: some observe only while others receive interventions; they're assigned randomly to either continue usual treatments or get additional artery embolization.
How Is the Trial Designed?
4Treatment groups
Experimental Treatment
Active Control
Group I: Interventional Cohort: Treatment ArmExperimental Treatment1 Intervention
Group II: Experimental: Interventional Cohort: Treatment ArmExperimental Treatment1 Intervention
Group III: Standard of Care Surgery OnlyActive Control1 Intervention
Group IV: Standard of Care Medical Management OnlyActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Cerenovus, Part of DePuy Synthes Products, Inc.

Lead Sponsor

Trials
10
Recruited
5,600+

Published Research Related to This Trial

Middle meningeal artery embolization is a safe and effective treatment for chronic subdural hematomas, showing a low recurrence rate of 4.1% and a reoperation rate of 4.2% among 382 patients studied.
Using Onyx as the embolic agent resulted in the lowest rates of recurrence and complications, while a combination of polyvinyl alcohol and coils led to the best overall clinical outcomes, suggesting that the choice of embolic agent can significantly impact treatment success.
Embolic Agent Choice in Middle Meningeal Artery Embolization as Primary or Adjunct Treatment for Chronic Subdural Hematoma: A Systematic Review and Meta-analysis.Ku, JC., Dmytriw, AA., Essibayi, MA., et al.[2023]
In a study of 61 patients with recurrent subdural hematoma, MMA embolization using diluted n-butyl cyanoacrylate (n-BCA) achieved complete obliteration of the targeted arteries in 100% of cases, demonstrating high efficacy in preventing further bleeding.
The procedure showed a low complication rate, with only 5% of patients experiencing recurrence of subdural hematoma and minimal risks of serious side effects such as cranial nerve palsy or stroke.
Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Using N-Butyl Cyanoacrylate With D5W Push Technique.Majidi, S., Matsoukas, S., De Leacy, RA., et al.[2022]
MMA embolization is a safe and effective treatment for chronic subdural hematoma (CSDH), with a low recurrence rate of 3.6% and no reported complications in a review of 15 studies involving 193 procedures.
In our clinical experience with 8 patients treated using Onyx, all experienced symptom relief and significant reduction in hematoma size, further supporting the efficacy of this minimally invasive approach.
Safety and Effectiveness of Embolization for Chronic Subdural Hematoma: Systematic Review and Case Series.Waqas, M., Vakhari, K., Weimer, PV., et al.[2020]

Citations

Middle Meningeal Artery Embolization With n‐Butyl ...The aim of this study is to evaluate safety/effectiveness of TRUFILL n‐butyl cyanoacrylate versus standard‐of‐care alone for middle meningeal ...
Study Details | NCT04816591 | Middle Meningeal Artery ...This is a prospective, multi-center, open-label, randomized controlled study in which subjects can receive standard of care (SOC) alone or SOC and TRUFILL n-BCA ...
Middle Meningeal Artery Embolization for Chronic ...Middle meningeal artery embolization using n-butyl cyanoacrylate for chronic subdural hematoma: technical aspects and clinical outcomes. J ...
A101 Middle meningeal artery embolisation for treatment ...Statistically significant treatment benefit of using TRUFILL n-BCA versus SOC across both cohorts (with or without surgery) was demonstrated (p=0.044). eMMA ...
Multidisciplinary consensus-based statement on the ...The aim of this work is to provide a consensus-based statement from a multidisciplinary panel on the current role of MMAE in patients with cSDH.
The membrane studyA prospective, multi-center, randomized controlled pivotal study to evaluate the safety and effectiveness of trufill® NBCA embolization of the middle meningeal ...
Middle meningeal artery embolization for chronic subdural ...We conducted a systematic review and individual patient data meta-analysis to evaluate middle meningeal artery embolization (MMAE) in adults ...
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