Jared Knopman, MD, Director of Cerebrovascular Surgery and Interventional Neuroradiology, last week presented results of the EMBOLISE trial at the International Stroke Conference (ISC) 2024 in Phoenix, Arizona. Dr. Knopman has been pioneering the use of endovascular treatment of subdural hematomas for nearly a decade, and he was the national Co-PI for the EMBOLISE trial. His ISC presentation reported on 400 patients treated across nearly 40 national centers.
The trial, which analyzed the role of MMA embolization in patients undergoing surgical evacuation of subdural hematoma, showed powerful, statistically significant benefits for patients. Endovascular embolization of the middle meningeal artery (MMA) was shown to reduce hematoma recurrence rates in patients who had undergone surgery by three-fold compared to surgery alone, with no increase in adverse events. The trial evaluating the role of embolization in non-surgical subdural hematoma patients is ongoing and expected to complete enrollment later this year.
“It is extremely gratifying to present evidence supporting what I have developed and personally seen over the past decade,” says Dr. Knopman. “Discovering that subdural hematomas have an arterial component that could be treated with embolization dramatically changed the landscape of our understanding of this pathology, and allowed us to conduct this trial. Sparing patients the risks of open surgery is a major advance in neurosurgery, and I am delighted to be among the first to offer it and now officially see it become part of standard of care. I look forward to seeing the procedure become available in hospitals everywhere, offering thousands of patients annually the benefits of this advance.”
The nationwide FDA-approved trial was designed based on Dr. Knopman’s early results and publications, using the Onyx Liquid Embolic System (LES) to treat chronic subdural hematomas, which is a common condition in elderly patients. (Read Comeback of the Year, the story of the 2017 patient who agreed to be the first one treated with this innovative procedure, which got him back to running in just a few weeks.) Dr. Knopman had first published the results of the procedure in the journal Operative Neurosurgery in 2017, reporting on the first five patients in the world treated with embolization in lieu of open surgery.
“I am proud of Dr. Knopman for once again demonstrating the innovation and creativity of our neurosurgical team,” says Dr. Philip Stieg, Chairman of Neurological Surgery at NewYork-Presbyterian/Weill Cornell Medical Center. “The benefits to patients are significant when we can offer them a treatment that effectively treats a pathology while minimizing intrusion into the brain. This is a major advance for the most common neurosurgical disease, and it’s very much in keeping with our drive to develop minimally invasive treatments for a wide range of neurosurgical conditions.”
The ISC is the annual meeting hosted by the American Stroke Association, part of the American Heart Association, dedicated to the science and treatment of cerebrovascular disease and brain health.
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