RT Journal Article SR Electronic 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 FD BMJ Publishing Group Ltd. SP 1209 OP 1213 DO 10.1136/neurintsurg-2020-016048 VO 12 IS 12 A1 Eimad Shotar A1 Louis Meyblum A1 Kevin Premat A1 Stéphanie Lenck A1 Vincent Degos A1 Teodor Grand A1 Jonathan Cortese A1 Arnaud Pouvelle A1 Geoffroy Pouliquen A1 Samuel Mouyal A1 Anne-Laure Boch A1 Alexandre Carpentier A1 Nader-Antoine Sourour A1 Bertrand Mathon A1 Frédéric Clarençon YR 2020 UL http://jnis.bmj.com/content/12/12/1209.abstract AB 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.