Complications of Middle Meningeal Artery Embolization - A Systematic Review and Meta-Analysis.

Autor: Shafi M; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: mahnoorshafi21@gmail.com., Badikol SR; Department of Pharmaceutical Economics and Policy, Massachusetts College of Pharmacy and Health Sciences, Boston, MA., Gerstl JVE; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Nawabi NLA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Sukumaran M; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Kappel AD; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Feroze AH; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Smith TR; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Mekary RA; Department of Pharmaceutical Economics and Policy, Massachusetts College of Pharmacy and Health Sciences, Boston, MA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Aziz-Sultan MA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI: 10.1016/j.wneu.2024.11.124
Abstrakt: Background: Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma (cSDH). The aim of this systematic review and meta-analysis was to establish estimates of the pooled incidence for complications following MMAE.
Methods: PubMed, Embase and Cochrane were searched for studies reporting complications following MMAE through January 2023. A random effects model was utilized to calculate the pooled incidence of complications stratified based on whether studies excluded patients with comorbidities. PRISMA checklist was followed.
Results: A final 34 studies containing 921 patients undergoing MMAE were included that reported 35 complications. Neurological complications were reported in seven studies with an overall pooled incidence of 3.8%(95%CI: 2.6%-5.5%). Across these studies, there was a pooled incidence of 4.9% (95%CI: 2.9%-8.0%), 3.0% (95%CI: 1.7%-5.3%), and 2.1% (95%CI: 0.4%-9.7%) in studies that did not exclude, did not mention, or excluded patients with comorbidities respectively. Similarly, seven studies reported cardiovascular complications with an overall pooled incidence of 3.6%(95%CI: 2.4%-5.4%), four studies reported infectious complications with an overall pooled incidence of 2.9%(95%CI: 1.9%4.5%), and three studies reported for miscellaneous complications with an overall pooled incidence of 3.1%(95%CI: 2.0%-4.8%). Further subgroup analysis revealed the pooled incidence of cardiovascular complications was3.2%(95%CI: 1.7%-6.1%) in studies that did not exclude patients with comorbidities, 4.1%(95%CI: 2.3%-7.1% in studies that did not specify the exclusion of such patients, and 1.8%(95CI: 0.2%-11.5% in studies that excluded these patients. Similarly, the incidence of infectious complications was 3.3%(95%CI: 1.7%-6.2%), 2.7%(95%CI: 1.5%-5.0%), and 1.8%(95%CI: 0.2%-11.5%) across these groups. respectively. Miscellaneous complications were reported at 4.0%(95%CI: 2.2%-7.2%), 2.3%(95%CI: 1.1%-4.6%), and 3.1%(95%CI: 0.9%-10.1%), respectively.
Conclusions: The published literature suggests that MMAE is a generally well-tolerated procedure with a low risk of significant complications.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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