2024 middle meningeal artery embolization trials: A comprehensive review of past, recent, and ongoing trials.
Avi A Gajjar, Ali Naqvi, John Y Chen et al.
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In 30 seconds
This systematic review examined published and ongoing clinical trials of middle meningeal artery embolization (MMAE) for chronic subdural hematoma. It identified seven published trials and 15 ongoing trials. The review reports that landmark randomized controlled trials, including EMBOLISE, STEM, and MAGIC-MT, found reductions in hematoma recurrence and surgical rescue with MMAE, supporting its use alongside surgery and, for selected patients, as a standalone approach. The abstract does not provide effect sizes. It also notes variation in patient selection, embolic materials, and outcome measures across trials.
Key findings
- The review identified seven published trials and 15 ongoing trials evaluating MMAE for chronic subdural hematoma.
- Landmark randomized trials reported reductions in hematoma recurrence and surgical rescue with MMAE.
- Evidence supports MMAE as an adjunct to surgery and a potential standalone therapy for selected patients.
- Trials vary in patient selection criteria, embolic materials, and endpoints.
Why it matters
MMAE is an emerging minimally invasive option for chronic subdural hematoma, and trial evidence summarized here suggests it may reduce recurrence and the need for surgical rescue. The review also highlights unresolved differences in how patients are selected and outcomes assessed, making ongoing trials important for clarifying which patients may benefit and how best to deliver the procedure.
What to keep in mind
The review reports substantial variability across trials in patient selection, embolic materials, and endpoints, limiting standardization and comparison of findings.