Middle Meningeal Artery Coagulation During Burr-Hole Drainage for Chronic Subdural Haematoma
Official title: BURR-MMA: A Prospective Pilot Feasibility Study of Intra-operative Middle Meningeal Artery Coagulation During Burr-Hole Surgery for Chronic Subdural Haematoma
Run by University College, London · NCT07549893 · Data updated 2026-11-12
This study tests whether safely coagulating small branches of the middle meningeal artery during burr-hole drainage can reduce recurrence of chronic subdural haematoma in adults receiving standard surgical care.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 30 (estimated) |
| Sponsor | University College, London Academic / other |
| Drugs / interventions | radiation |
| Locations | 1 site (London) |
| Status | Recruiting |
| Started | August 1, 2026 |
| Main results expected | July 1, 2027 |
| Study ends | December 1, 2027 |
| Registry record updated | August 4, 2026 |
| Trial ID | NCT07549893 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults aged 18 years or older undergoing burr-hole drainage for chronic or subacute subdural hematoma, where the surgeon considers the MMA adjunct feasible and safe to attempt.
✕Probably not a fit
Patients in whom the MMA adjunct is not technically feasible or who experience intraoperative bail-out will not receive the adjunct benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This is a single-centre feasibility study evaluating a workflow-integrated technique to partially coagulate distal branches of the middle meningeal artery during routine burr-hole drainage for chronic or subacute subdural hematoma. Using pre-operative CT mapping and neuronavigation, surgeons perform limited bipolar coagulation of MMA branches through the planned burr-hole, without extra imaging or implants. The primary aims are technical deliverability, safety, and fidelity of the procedure, with Day 90 follow-up and exploratory outcomes to inform design for a future multicentre study. All imaging is part of routine care, and no additional radiation is introduced for study participation. The trial is IDEAL Stage 2a, single-arm, enrolling 20-30 adults.
Why it matters
Potential benefit: If successful, this approach could lower recurrence rates after burr-hole drainage by targeting the blood supply to the outer membrane of the hematoma.
How similar studies have gone: Endovascular MMA embolisation has shown recurrence reduction, but this study tests a different in-workflow, intraoperative coagulation approach that is less invasive than embolisation.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age ≥18 years. * Chronic or subacute subdural haematoma scheduled for burr-hole evacuation. * Treating surgeon considers the CT- and navigation-guided MMA adjunct technically feasible and safe to attempt, recognising that the adjunct may be abandoned intra-operatively according to protocol bail-out criteria. * Written informed consent, or consultee declaration under the Mental Capacity Act (MCA), with re-consent if capacity returns. Consented participants who meet eligibility criteria will be enrolled sequentially until the target sample size of 20-30 participants is reached. No randomisation is used in this feasibility phase. Exclusion Criteria: * Acute subdural haematoma requiring craniotomy or decompressive surgery. * Prior ipsilateral MMA embolisation. * Clear contraindication to pre-operative CT * Inability to complete Day-90 follow-up. * Pregnancy or breastfeeding (due to radiation exposure from CT imaging as part of standard clinical care). If CT is non-diagnostic or cannot be performed, participants will continue with standard burr-hole evacuation without the MMA adjunct; this does not constitute a protocol deviation.
Where it's running
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National Hospital for Neurology and Neurosurgery
London, United Kingdom Recruiting
Study contacts
- Study coordinator: Jigishaa Moudgil-Joshi, MRCS, MBChB
- Email: burrmmatrial@gmail.com
- Phone: 020 3456 7890
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
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Seeing if antibiotics given after surgery reduce recurrence of chronic subdural hematoma
This trial will test whether a short course of amoxicillin‑clavulanate given after surgery can lower the chance of chronic subdural hematoma coming back in adults.
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Enhanced recovery pathway for burr-hole drainage in chronic subdural hematoma patients
This project tests whether an enhanced recovery protocol for adults having burr-hole drainage for chronic subdural hematoma can reduce recurrence and complications compared with past patients.
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Embolization of the middle meningeal artery for treating chronic subdural hematomas
This study is testing if blocking a specific artery can help people with chronic subdural hematomas either when combined with surgery or as a standalone treatment for those who can’t have surgery.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.