Outcomes of Particle versus Liquid Embolic Materials Used in Middle Meningeal Artery Embolization for the Treatment of Chronic Subdural Hematoma.

Autor: Krothapalli N; Department of Neurology, University of Connecticut, Farmington, Connecticut, USA; Ayer Neuroscience Institute, Hartford, Connecticut, USA., Patel S; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Interventional Neuroradiology, Hartford Hospital, Hartford, Connecticut, USA., Fayad M; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Interventional Neuroradiology, Hartford Hospital, Hartford, Connecticut, USA., Elmashad A; Department of Neurology, University of Connecticut, Farmington, Connecticut, USA; Ayer Neuroscience Institute, Hartford, Connecticut, USA., Killory B; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Neurosurgery, Hartford Hospital, Hartford, Connecticut, USA., Bruno C; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Interventional Neuroradiology, Hartford Hospital, Hartford, Connecticut, USA., Sussman E; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Neurosurgery, Hartford Hospital, Hartford, Connecticut, USA., Alberts M; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Neurology, Hartford Hospital, Hartford, Connecticut, USA., Ollenschleger M; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Interventional Neuroradiology, Hartford Hospital, Hartford, Connecticut, USA., Kureshi I; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Neurosurgery, Hartford Hospital, Hartford, Connecticut, USA., Mehta T; Ayer Neuroscience Institute, Hartford, Connecticut, USA; Department of Interventional Neuroradiology, Hartford Hospital, Hartford, Connecticut, USA. Electronic address: Tapan.Mehta@hhchealth.org.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2023 May; Vol. 173, pp. e27-e36. Date of Electronic Publication: 2023 Jan 24.
DOI: 10.1016/j.wneu.2023.01.077
Abstrakt: Background: Early evidence suggests that middle meningeal artery (MMA) embolization is an efficacious minimally invasive neuroendovascular technique for the management of chronic subdural hematoma (cSDH). Particle and liquid embolic materials are commonly used to embolize the MMA; however, studies comparing the safety and outcomes between these 2 materials are limited.
Methods: Patients ≥18 years old who had MMA embolization for cSDH between July 15, 2020 and May 1, 2022 were retrospectively identified from a single-center database. The primary safety, radiation dosage, fluoroscopy time, and radiographic and clinical outcomes were compared between particle and liquid embolization.
Results: In a cohort of 116, 48 (41.38%) were treated with liquid embolic material and 68 (58.62%) were treated with particle. The median age of the cohort was 73 years in the particle group and 73.5 years in the liquid embolic group. There was no significant difference in radiation dose or duration among both groups. There was no reported mortality associated with the procedure. One patient experienced nondisabling ischemic stroke in the particle group. Based on imaging follow-up, 3 patients in the particle group and 1 in the liquid embolic group had asymptomatic recurrence. One patient in each group had symptomatic recurrence requiring hematoma evacuation. The index median size of hematoma was 12 mm in the particle group and 11 mm in the liquid embolic group. At approximately 1 month follow-up, the median size of hematoma reduced to 6 mm in both groups.
Conclusions: Our series shows that liquid embolic and particle embolization are equally safe and effective among patients undergoing MMA embolization for management of cSDH.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: