Adjunctive middle meningeal artery embolization for chronic subdural hematoma: A systematic review and meta-analysis of eight randomized trials.
Barbara Figueiredo Bonatti, Pandora Eloa Oliveira Fonseca, Davi Ricardo Soares Gama de Amorim et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and safety of adjunctive middle meningeal artery embolization (MMAE) in patients with chronic subdural hematoma (CSDH) across eight randomized trials involving 1961 patients. The study found that MMAE plus surgery significantly reduced recurrence compared to surgery alone, with a risk ratio of 0.63 (95% CI 0.46-0.85).
Key findings
- MMAE plus surgery reduced recurrence in CSDH compared to surgery alone (RR 0.63, 95% CI 0.46-0.85).
- Trial sequential analysis supported the robustness of the recurrence reduction finding.
- Safety outcomes were comparable between MMAE plus surgery and surgery alone.
- Exploratory analyses suggested associations between recurrence and mean age or anticoagulation use.
Why it matters
Understanding the impact of adjunctive MMAE on recurrence rates in CSDH can inform surgical decision-making and improve patient outcomes. The findings highlight a potential strategy to enhance treatment efficacy.
What to keep in mind
The exploratory analyses were limited by the small number of included trials and the use of aggregate-level data.