Introduction SDHs are more prevalent among the elderly and can cause significant morbidity and mortality. n-BCA has proven to be an effective and safe agent for embolization of middle meningeal artery (MMA).
Aim of Study We present a retrospective analysis of patients who underwent MMA embolization for SDH.
Methods We included 31 patients who were diagnosed with chronic or acute-on-chronic SDH and underwent MMA embolization with n-BCA. Primary endpoint was >50% SDH reduction, secondary endpoint was all-cause mortality. Patients were separated into outcome groups and their variables were compared using Wilcoxon rank-sum, or Fisher’s exact tests. Through logistic regression we determined variables that influenced SDH reduction and mortality.
Results Hypertension (n=23; p=0.04), antiplatelet (AP) (n=8; p=0.02), and MMA embolization via radial approach (n=18; p=0.004) had <50% SDH reduction. Embolization via femoral approach (n=13; p=0.004), and longer mean fluoroscopy times (43.2 minutes vs. 28.2 minutes; p=0.03) had >50% SDH reduction. On logistic regression, femoral approach (OR 12; 95% CI 1.9, 76.4; p=0.004) and longer fluoroscopy times (OR 1.1, 95% CI 1.0, 1.1; p=0.03) had >50% of SDH reduction. Mortality in patients (n=6) was not associated with SDH or the procedure (p>0.05.)
Conclusion Our small sample size underestimates the effect some variables may have on radiographic and clinical outcomes. Hypertension and use of AP may play a role in hematoma resolution; however, a bigger cohort is needed to confirm these hypotheses. Future randomized controlled trials will help establish MMA embolization as the primary method for SDH management given its safety and efficacy.
Disclosure of Interest Nothing to disclose
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