TY - JOUR T1 - Middle meningeal artery embolization reduces the post-operative recurrence rate of at-risk chronic subdural hematoma JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 1209 LP - 1213 DO - 10.1136/neurintsurg-2020-016048 VL - 12 IS - 12 AU - Eimad Shotar AU - Louis Meyblum AU - Kevin Premat AU - Stéphanie Lenck AU - Vincent Degos AU - Teodor Grand AU - Jonathan Cortese AU - Arnaud Pouvelle AU - Geoffroy Pouliquen AU - Samuel Mouyal AU - Anne-Laure Boch AU - Alexandre Carpentier AU - Nader-Antoine Sourour AU - Bertrand Mathon AU - Frédéric Clarençon Y1 - 2020/12/01 UR - http://jnis.bmj.com/content/12/12/1209.abstract N2 - Background Embolization of the middle meningeal artery (MMA) has emerged as a potential treatment of chronic subdural hematomas (CSDHs).Objective To evaluate the impact on recurrence rate of postsurgical embolization of CSDH in patients with a higher than average risk of recurrence.Methods A monocentric retrospective study was performed on retrospectively collected data. From March 2018 to December 2019, embolization of the MMA was proposed as an adjunct postoperative treatment after burr-hole surgery in patients operated for a recurrent CSDH or a CSDH with an independent recurrence risk factor, including antiplatelet therapy, full anticoagulation therapy, coagulation disorder, hepatopathy, or chronic alcoholism. Patients who had undergone postoperative embolization were compared with a historic group of patients operated between March 2016 and March 2018, selected based on the same inclusion criteria.Results During the study period, 89 patients (with 74 unilateral and 15 bilateral CSDHs) were included and underwent an embolization procedure, leading to 91 out of a total of 104 MMA being embolized (88%). These were compared with 174 patients (138 unilateral and 36 bilateral CSDH) in the historic control group. One major procedure-related adverse event was registered. Four of the 89 patients (4%) required surgery for a CSDH recurrence in the embolization group, significantly less than the 24 of 174 patients (14%) in the control group (OR=0.28, 95% CI 0.07 to 0.86, p=0.02).Conclusions Postsurgical embolization of the MMA may reduce the recurrence rate of CSDHs with a risk factor of recurrence. ER -