Next Steps Following EMBOLISE Trial and Addressing Unmet Needs for Subdural Hematomas: Jason M. Davies, MD, PhD

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The assistant professor of neurosurgery and biomedical informatics at the State University of New York at Buffalo discussed the questions that still remain following the EMBOLISE trial and the use of embolization in the treatment of subacute and subdural hematoma. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"We have a number of planned secondary analyses looking at imaging aspects, how much of the artery you glue, what portion of the artery you glue, health economic outcomes, and whether it can reduce costs of the system and improve quality of life."

Subdural hematomas (SDH) can be divided into 3 groups based on chronology: acute, subacute, and chronic. A subacute SDH is defined as a hematoma that evolves from an acute SDH within 4 to 21 days of head injury. A chronic SDH, which occurs 21 days after head injury, is one of the most common traumatic conditions in the elderly population and dose not necessarily develop from an acute SDH. Although surgical management is technically straightforward, high recurrence rates and comorbidities against elders make minimally invasive alternatives for treatment attractive.

At the 2024 International Stroke Conference (ISC), held February 7-9, in Phoenix, Arizona, researchers presented data from the EMBOLISE trial (NCT04402632), a multicenter, randomized interventional trial of 400 patients with symptomatic subacute or chronic SDH. Led by Jason M. Davies, MD, PhD, patients were randomly assigned 1:1 to either surgery alone or surgery with adjunctive middle meningeal artery (MMA) embolization using the Onyx Liquid Embolic System. At 90 days, results showed that treatment using the embolization system resulted in a 3-fold decrease in the rate of hematoma recurrence/progression requiring surgical drainage, the primary end point.

Following the presentation, Davies, an assistant professor of neurosurgery and biomedical informatics at the State University of New York at Buffalo, sat down with NeurologyLive® to describe the next steps in research and what’s left for EMBOLISE. He spoke about the plan to assess those with larger and smaller hematomas, the secondary analyses still left to complete, and the additional questions that remain. Furthermore, he spoke on the unmet needs for this patient population, the challenges that come with treating elders, and managing complications associated with traditionally used surgical procedures.

Click here for more coverage of ISC 2024.

REFERENCE
1. Knopman J, Davies JM, Harbaugh RE, et al. The EMBOLISE study: embolization of the middle meningeal artery with Onyx Liquid Embolic System in the treatment of subacute and chronic subdural hematoma. Presented at: International Stroke Conference; February 7-9, 2024; Phoenix, AZ. LB28
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