Endovascular embolisation of the middle meningeal artery to treat chronic subdural haematomas: Effectiveness, safety, and the current controversy. A systematic review

R Martinez-Perez; N Rayo; A Tsimpas

doi:10.1016/j.nrl.2020.04.023

Endovascular embolisation of the middle meningeal artery to treat chronic subdural haematomas: Effectiveness, safety, and the current controversy. A systematic review

Neurologia (Engl Ed). 2020 Jul 7:S0213-4853(20)30133-X. doi: 10.1016/j.nrl.2020.04.023. Online ahead of print.

[Article in English, Spanish]

Authors

R Martinez-Perez¹, N Rayo², A Tsimpas³

Affiliations

¹ Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, Ohio, EE. UU.. Electronic address: rafa11safin@hotmail.com.
² Department of Biology, Western University, London, Ontario, Canadá.
³ Division of Neurosurgery, Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, Illinois, EE. UU.

PMID: 32651091
DOI: 10.1016/j.nrl.2020.04.023

Abstract

Introduction: Chronic subdural haematoma (CSDH) represents a clinical challenge due to its high recurrence rate. Endovascular middle meningeal artery embolisation (eMMAE) has emerged as an alternative for those patients presenting health problems or multiple recurrences of CSDH. Despite several encouraging reports, the safety profile, indications, and limitations of the technique are not clearly established.

Development: This study aimed to evaluate the current evidence on eMMAE in patients with CSDH. We performed a systematic review of the literature, following the PRISMA guidelines. Our search yielded a total of 6 studies, in which a total of 164 patients with CSDH underwent eMMAE. The recurrence rate across all studies was 6.7%, and complications occurred in up to 6% of patients.

Conclusions: eMMAE is a feasible technique for treating CSDH, with a relatively low recurrence rate and an acceptable rate of complications. Further prospective and randomised studies are needed to formally establish a clear profile of the safety and effectiveness of the technique.

Keywords: Arteria meníngea; Embolisation; Embolización; Endovascular technique; Hematoma subdural; Meningeal artery; Neurocirugía; Neurosurgery; Recurrence; Recurrencia; Subdural haematoma; Terapéutica; Treatment; Técnica endovascular.

Publication types

Review