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Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis
OBJECTIVE: Chronic subdural hematoma (CSDH) is a common and debilitating neurological condition whose treatments, including burr hole drainage and craniotomy, suffer from high rates of recurrence and complication. Embolization of the middle meningeal artery (EMMA) is a promising minimally invasive a...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392769/ https://www.ncbi.nlm.nih.gov/pubmed/33525919 http://dx.doi.org/10.1177/1591019921990962 |
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author | Dian, Joshua Linton, Janice Shankar, Jai JS |
author_facet | Dian, Joshua Linton, Janice Shankar, Jai JS |
author_sort | Dian, Joshua |
collection | PubMed |
description | OBJECTIVE: Chronic subdural hematoma (CSDH) is a common and debilitating neurological condition whose treatments, including burr hole drainage and craniotomy, suffer from high rates of recurrence and complication. Embolization of the middle meningeal artery (EMMA) is a promising minimally invasive approach to manage CSDH in a broad set of patients. METHODS: To evaluate the efficacy and safety of EMMA, a database search was conducted including the terms “subdural hematoma; embolization; embolized; middle meningeal” was performed and yielded a total of 260 results. Following exclusion based on predefined criteria, a total of four studies were identified and outcomes including recurrence rates and complication rates were extracted for analysis. RESULTS: Four studies including intervention and control groups were included with a total of n = 888 patients. The relative risk of CSDH recurrence in the EMMA (3.5%) compared to control group (23.5%) was significantly reduced when EMMA was performed (risk ratio = 0.17; 95% confidence interval (CI) 0.05–0.67). In addition, rates of complication were not significantly different between patients with conventional therapy and those who received EMMA (OR = 0.77; 95 confidence interval (CI) 0.3–1.99). CONCLUSION: Based on limited data, EMMA reduces the risk of recurrence by 20% compared to surgical treatment for CSDH. |
format | Online Article Text |
id | pubmed-8392769 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-83927692021-08-28 Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis Dian, Joshua Linton, Janice Shankar, Jai JS Interv Neuroradiol Subdural Hematoma OBJECTIVE: Chronic subdural hematoma (CSDH) is a common and debilitating neurological condition whose treatments, including burr hole drainage and craniotomy, suffer from high rates of recurrence and complication. Embolization of the middle meningeal artery (EMMA) is a promising minimally invasive approach to manage CSDH in a broad set of patients. METHODS: To evaluate the efficacy and safety of EMMA, a database search was conducted including the terms “subdural hematoma; embolization; embolized; middle meningeal” was performed and yielded a total of 260 results. Following exclusion based on predefined criteria, a total of four studies were identified and outcomes including recurrence rates and complication rates were extracted for analysis. RESULTS: Four studies including intervention and control groups were included with a total of n = 888 patients. The relative risk of CSDH recurrence in the EMMA (3.5%) compared to control group (23.5%) was significantly reduced when EMMA was performed (risk ratio = 0.17; 95% confidence interval (CI) 0.05–0.67). In addition, rates of complication were not significantly different between patients with conventional therapy and those who received EMMA (OR = 0.77; 95 confidence interval (CI) 0.3–1.99). CONCLUSION: Based on limited data, EMMA reduces the risk of recurrence by 20% compared to surgical treatment for CSDH. SAGE Publications 2021-02-01 2021-08 /pmc/articles/PMC8392769/ /pubmed/33525919 http://dx.doi.org/10.1177/1591019921990962 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Subdural Hematoma Dian, Joshua Linton, Janice Shankar, Jai JS Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis |
title | Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis |
title_full | Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis |
title_fullStr | Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis |
title_full_unstemmed | Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis |
title_short | Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis |
title_sort | risk of recurrence of subdural hematoma after emma vs surgical drainage – systematic review and meta-analysis |
topic | Subdural Hematoma |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392769/ https://www.ncbi.nlm.nih.gov/pubmed/33525919 http://dx.doi.org/10.1177/1591019921990962 |
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