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O-052 Middle meningeal artery embolization for subdural hematoma: meta-analysis of randomized controlled trials
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  1. A Wang1,
  2. H Shakil2,
  3. B Drake1
  1. 1Division of Neurosurgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
  2. 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

Abstract

Background Embolization of the middle meningeal artery embolization is a novel neuroendovascular therapy for chronic subdural hematoma. Recently, a number of randomized control trials were conducted to its efficacy in reducing the recurrence or progression rate of chronic subdural hematoma.

Methods Preliminary data were reviewed from three randomized control trials (MAGIC-MT, EMBOLISE, STEM: SQUID) presented at the International Stroke Conference 2024. Meta-analysis was undertaken to compare patients undergoing middle meningeal artery embolization and standard care (intervention group) compared to standard care alone (control group); primary endpoints from each study (symptomatic recurrence, symptomatic progression, major adverse event, neurologic deterioration, stroke, MI, and/or death) were analyzed.

Results A total of 1432 patients (712 intervention group, 720 control group) were included among the three trials. Heterogeneity was low (I2 = 5%, τ = 0.0133, p = 0.35), therefore a common-effect model was used. The primary endpoint was met in 58 patients (8.1%) in the intervention group compared to 128 patients (17.8%) in the control group. MMA embolization combined with standard management was associated a significantly lower rate of the primary outcome when compared to standard management alone (8.1% vs 17.8%; RR 0.46, 95% CI, 0.34–0.61; p < 0.001; NNT 10.3).

Conclusion This preliminary meta-analysis demonstrates that middle meningeal artery embolization is effective in reducing symptomatic recurrence, symptomatic progression, major adverse event, neurologic deterioration, stroke, MI, and/or death among patients with chronic subdural hematoma. Further analysis will be performed once the trials are published in peer-reviewed journals.

Disclosures A. Wang: None. H. Shakil: None. B. Drake: None.

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