Article Text
Abstract
Introduction The use of middle meningeal artery (MMA) embolization has emerged as a potential treatment for chronic subdural hematoma (cSDH), with an aim to decrease the need for additional treatment. However, specific characteristics of the MMA embolization procedure are yet to be optimized, such as the choice behind unilateral or bilateral embolization. In this study, we aim to explore the need for retreatment after embolization depending on the laterality of the initial approach.
Methods All patients presenting to our center for MMA embolization between August 2019 and February 2024 were eligible for inclusion in this study. While patients were prospectively enrolled, details related to factors such as presentation, procedures, and outcomes were abstracted through retrospective chart review. Statistical analysis was performed utilizing two-tailed student’s t-test with statistical significance set at p < 0.05.
Results A total of 138 patients were included in the present analysis, with a mean age of 71.6 years. The majority of included patients were male (73.2%), had a history of hypertension (66.7%), and presented for the MMA procedure with symptoms (59.4%) ranging from headache to unsteady gait, among others. Unilateral embolization was performed in 39.9% (n = 55) of patients and bilateral embolization was performed in the other 60.1% of patients (n = 83). Retreatment after embolization was required in 8.7% of the cohort (n = 12), with 12.7% of the unilateral embolization cohort requiring additional treatment compared to 6% of patients in the bilateral embolization group (p = 0.087).
Discussion In summary, although not statistically significant, a greater proportion of patients who received unilateral embolization required additional treatment. While future work is required to fully explore this potential association in a larger cohort, performing bilateral MMA embolization may serve as a method to reduce need for additional treatment, improving both patient quality of life and efficient use of healthcare resources.
Disclosures R. Kalagara: None. A. Devarajan: None. A. Rao: None. A. Bhimani: None. B. Philbrick: None. D. Goldman: None. K. Perlman: None. J. Fifi: None. H. Shoirah: None. S. Majidi: None. C. Kellner: None. J. Mocco: None. T. Shigematsu: None.