Trends and Outcomes of Primary, Rescue, and Adjunct Middle Meningeal Artery Embolization for Chronic Subdural Hematomas

Middle meningeal artery embolisation: The review of a new treatment for chronic subdural hematomas

“…is could be attributed to the relative increase in the population size compared to the literature review by Di Cristofori et al [13] e inclusion of the retrospective study done by Nia et al published in August 2022 increased the population size from 727 to 973 without reports of additional failures in MMAE. [51] Reflecting on the population size of the included articles, the results of the failure rate were similar to the results deducted by Di Cristofori et al [13] Reflection on the indication of MMAE application and its corresponding failure rate, a variance has been noted. is could be attributed to the overlap among MMAE indications for the failure count.…”

“…[13] e implementation of the results reported by Nia et al in August 2022 along with the results of the article by Di Cristofori et al is depicted in Table 8. [13,51] With a similar MMAE group population, Nia et al reported much lower rates of failure (0.47% vs. 3.9%). [51] Although a similar result can be deducted concerning the rate of recurrence after conventional technique application, this can be attributed to the large population (4050) studied by Nia et al relative to the 727 patients reported by Cristofori et al [13,51] DISCUSSION Indications for MMA embolization through the literature is review of literature unveiled the application of MMAE for the following indications: a standalone procedure, an adjuvant treatment at the time of first surgery, for prevention of recurrence after first surgical evacuation, as a treatment after recurrence after first surgical evacuation without second surgery and as a treatment after recurrence after second surgical evacuation.…”

“…[43] Out of 520 patients included in those articles, only 82 had an MMAE procedure for recurrence without surgery. e remaining patients were indicated for MMAE as either a standalone procedure or prophylactically after the first surgical intervention as by [9,28,39,40,51,74] e failure rate was 2.23% (12 patients out of 520 patients. the number of failures attributed to MMAE procedures done for recurrence without surgery was not indicated in any article.…”

“…Overall, the failure rate diminished with the inclusion of a large study published by Nia et al in 2022. [51]…”

Controversies in the Surgical Treatment of Chronic Subdural Hematoma: A Systematic Scoping Review

“…In 2022, Nia et al examined the use of MMA embolization as a primary standalone method for managing cSDH. They showed favorable treatment failure rates when compared to surgery for a specific patient population: their indications for the primary use of MMA embolization were of aged people (72 ± 12 years old) with a substantially high comorbidity index of 7,02 [ 124 ]. It is, however, a method that is not applicable in every patient and every institution, and the eligibility criteria are yet unclear [ 20 , 45 ].…”