Middle meningeal artery embolization reduces the post-operative recurrence rate of at-risk chronic subdural hematoma
| Autor: | Geoffroy Pouliquen, Arnaud Pouvelle, Frédéric Clarençon, Bertrand Mathon, Teodor Grand, Kevin Premat, Eimad Shotar, Alexandre Carpentier, Louis Meyblum, Stéphanie Lenck, Anne-Laure Boch, Jonathan Cortese, Nader-Antoine Sourour, Vincent Degos, Samuel Mouyal |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Middle meningeal artery medicine.medical_treatment Embolization procedure 030218 nuclear medicine & medical imaging 03 medical and health sciences Postoperative Complications 0302 clinical medicine Chronic subdural hematoma Recurrence Risk Factors medicine.artery Humans Medicine Embolization Risk factor Post operative Adverse effect Aged Retrospective Studies Aged 80 and over business.industry Retrospective cohort study General Medicine Middle Aged Plastic Surgery Procedures Embolization Therapeutic Meningeal Arteries Surgery Hematoma Subdural Chronic Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of NeuroInterventional Surgery. :neurintsurg-2020 |
| ISSN: | 1759-8486 1759-8478 |
| DOI: | 10.1136/neurintsurg-2020-016048 |
| Popis: | BackgroundEmbolization of the middle meningeal artery (MMA) has emerged as a potential treatment of chronic subdural hematomas (CSDHs).ObjectiveTo evaluate the impact on recurrence rate of postsurgical embolization of CSDH in patients with a higher than average risk of recurrence.MethodsA monocentric retrospective study was performed on retrospectively collected data. From March 2018 to December 2019, embolization of the MMA was proposed as an adjunct postoperative treatment after burr-hole surgery in patients operated for a recurrent CSDH or a CSDH with an independent recurrence risk factor, including antiplatelet therapy, full anticoagulation therapy, coagulation disorder, hepatopathy, or chronic alcoholism. Patients who had undergone postoperative embolization were compared with a historic group of patients operated between March 2016 and March 2018, selected based on the same inclusion criteria.ResultsDuring the study period, 89 patients (with 74 unilateral and 15 bilateral CSDHs) were included and underwent an embolization procedure, leading to 91 out of a total of 104 MMA being embolized (88%). These were compared with 174 patients (138 unilateral and 36 bilateral CSDH) in the historic control group. One major procedure-related adverse event was registered. Four of the 89 patients (4%) required surgery for a CSDH recurrence in the embolization group, significantly less than the 24 of 174 patients (14%) in the control group (OR=0.28, 95% CI 0.07 to 0.86, p=0.02).ConclusionsPostsurgical embolization of the MMA may reduce the recurrence rate of CSDHs with a risk factor of recurrence. |
| Databáze: | OpenAIRE |
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