Middle meningeal artery embolization for the treatment of unilateral large chronic subdural hematoma patients with significant midline shift: A single-center experience

作者全名："Niu, Yin; Zhang, Qiang; Jiang, Zhouyang; Li, Wenyan; Chen, Zhi"

作者地址："[Niu, Yin; Jiang, Zhouyang; Li, Wenyan; Chen, Zhi] Third Mil Med Univ, Southwest Hosp, Dept Neurosurg, Army Med Univ, Chongqing, Peoples R China; [Zhang, Qiang] 961st Hosp Chinese Peoples Liberat Army Joint Logi, Dept Neurosurg, Qiqihar, Heilongjiang, Peoples R China; [Li, Wenyan; Chen, Zhi] Third Mil Med Univ, Army Med Univ, Southwest Hosp, Dept Neurosurg, Chongqing 400038, Peoples R China"

通信作者："Li, WY; Chen, Z (通讯作者)，Third Mil Med Univ, Army Med Univ, Southwest Hosp, Dept Neurosurg, Chongqing 400038, Peoples R China."

来源：INTERVENTIONAL NEURORADIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001189281500001

JCR分区：Q3

影响因子：1.5

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Chronic subdural hematoma; middle meningeal artery; midline shift; interventional embolization; 3D-TOF MRA

摘要："Background: The amount of midline shift (MLS) considered safe for middle meningeal artery embolization (MMAE) in patients with chronic subdural hematoma (CSDH) has not been established. Whether MMAE could be used as upfront treatment for unilateral large CSDH patients with significant MLS (>1 cm) has not been reported. Objective: To investigate the efficacy and safety of MMAE in unilateral large CSDH patients with MLS > 1 cm. Methods: Eleven carefully selected CSDH patients with mild or moderate symptoms and significant MLS > 1 cm from 1 May 2021 to 31 August 2022 were included in the study. All patients were treated with MMAE using polyvinyl alcohol (PVA) particles. Outcomes were assessed clinically and with interval imaging studies at follow-up. Results: All 19 MMAs (unilateral embolization in three patients and bilateral embolization in eight patients) were successfully embolized. All 11 patients were followed for subsequent months, and there was no recurrence and enlargement of CSDH. Procedural adverse events, mortality, or complications were not observed. The average time to achieve a 50% reduction in MLS was approximately four weeks, while it took approximately eight weeks to achieve a 50% reduction in maximal volume. All 11 patients showed improvement in their neurological symptoms at three days post-operation, including four hemiplegic patients. Conclusions: MMAE may demonstrate safety in carefully selected CSDH patients with significant midline shift (MLS > 1 cm), particularly in those who are not suitable for surgery, thus providing a potential alternative approach."

基金机构：Chongqing medical scientific research project [2023MSXM102]

基金资助正文："The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article:This work was supported by the Chongqing medical scientific research project (grant number 2023MSXM102)."