Letter: Middle Meningeal Artery Embolization in Adjunction to Surgical Evacuation for Treatment of Subdural Hematomas: A Nationwide Comparison of Outcomes With Isolated Surgical Evacuation

In Reply: Middle Meningeal Artery Embolization in Adjunction to Surgical Evacuation for Treatment of Subdural Hematomas: A Nationwide Comparison of Outcomes With Isolated Surgical Evacuation

“…We appreciate the important points raised by Su et al 1 regarding our recent study entitled “Middle Meningeal Artery Embolization in Adjunction to Surgical Evacuation for Treatment of Subdural Hematomas: A Nationwide Comparison of Outcomes with Isolated Surgical Evacuation.” 2…”

“…Finally, emphasizing the points made by Su et al, 1 we would like to encourage future studies to investigate the controversial observations regarding factors affecting the outcome of MMAE and preoperative workup required for patient selection for MMAE, while we await the results of several ongoing trials on the efficacy of MMAE.…”

“…The authors 1 highlight the importance of considering middle meningeal artery diameter when choosing patients for primary or adjunctive MMAE. This is implied by the results of a recent multi-institutional study on a large sample, assessing predictors of MMAE failure, which found middle meningeal artery diameter to be the only predictor of failure after adjustment for several variables.…”

“…Su et al 1 mentioned the need for the identification of patients who would benefit most from MMAE and that concluding the long-term benefit and cost-effectiveness of MMAE is premature. Although we agree with these comments, we believe our study provides, while with its limitations, valuable evidence to urge future studies on these subjects.…”