Department of Neurosurgery, University of Manitoba, Manitoba, Canada.
Indigenous Health Librarian & Liaison Librarian for Community Health Sciences Neil John Maclean Health Sciences Library, University of Manitoba, Manitoba, Canada.
Interv Neuroradiol. 2021 Aug;27(4):577-583. doi: 10.1177/1591019921990962. Epub 2021 Feb 1.
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.
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.
Four studies including intervention and control groups were included with a total of = 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).
Based on limited data, EMMA reduces the risk of recurrence by 20% compared to surgical treatment for CSDH.
慢性硬脑膜下血肿（CSDH）是一种常见且使人虚弱的神经疾病，其治疗方法，包括颅骨钻孔引流和开颅手术，复发率和并发症发生率都很高。硬脑膜中动脉栓塞术（EMMA）是一种有前途的微创方法，可以广泛应用于 CSDH 的治疗。
为了评估 EMMA 的疗效和安全性，对包括“硬膜下血肿；栓塞；栓塞；脑膜中动脉”等术语的数据库进行了搜索，共得到 260 个结果。根据预先设定的标准进行排除后，共确定了 4 项研究，并提取了包括复发率和并发症发生率在内的结果进行分析。
共纳入了 4 项研究，包括干预组和对照组，共有 888 名患者。与对照组（23.5%）相比，EMMA 组（3.5%）CSDH 复发的相对风险显著降低（风险比=0.17；95%置信区间（CI）0.05-0.67）。此外，接受常规治疗和接受 EMMA 治疗的患者的并发症发生率没有显著差异（比值比=0.77；95%置信区间（CI）0.3-1.99）。
根据有限的数据，与 CSDH 的手术治疗相比，EMMA 可将复发风险降低 20%。
