Li Junhui, Chen Zhengwen, Shao Junjie, Jia Qi, Fan Zhixiang, Huang Qingfeng, Lu Xiaojian
Affiliated Hospital of Nantong University, Nantong, China.
Medical School of Nantong University, Nantong, China.
Neuroradiology. 2025 Sep 12. doi: 10.1007/s00234-025-03740-9.
To compare the efficacy and safety of middle meningeal artery embolization (MMAE) and burr hole drainage in the treatment of chronic subdural hematoma (CSDH).
Patients diagnosed with CSDH who underwent MMAE or surgical treatment were retrospectively recruited to this single-center study. Propensity score matching (PSM) analysis was carried out to compare the efficacy and safety of MMAE and burr hole drainage. Efficacy outcomes included hematoma clearance, cure, recurrence, and re-intervention rates within a 90-day postoperative follow-up period. Safety outcomes included the modified Rankin Scale (mRS) of 0-2 at the 90-day postoperative follow-up, procedure-related complications during hospitalization, and hospital stay length.
Among the 183 CSDH patients, 34.4% (63 patients) received MMAE and 65.6% (120 patients) underwent burr hole drainage surgery. The MMAE group showed a higher hematoma clearance rate (90.62±8.98% vs. 81.12±18.62%, P=0.005), higher cure rate (63.4% vs. 41.5%, P=0.047), and lower recurrence rate (2.4% vs. 14.6%, P=0.048) after PSM compared to the burr hole group. The re-intervention rates in the MMAE and burr hole groups showed no significant differences (2.4% vs. 7.3%, P=0.305). Safety outcomes favored the MMAE group, with a lower 90-day mRS score (0.34±0.53 vs. 0.73±0.55, P=0.02) and shorter hospital stay (6.41±2.53 days vs. 9.29±3.71 days, P<0.001). Surgery-related adverse events occurred in 4.9% of the MMAE group and 9.7% of the burr hole group patients (P=0.392).
MMAE was a safe and efficacious alternative procedure for CSDH treatment that showed a reduced recurrence rate.
比较脑膜中动脉栓塞术（MMAE）与钻孔引流术治疗慢性硬膜下血肿（CSDH）的疗效和安全性。
回顾性纳入本单中心研究中诊断为CSDH并接受MMAE或手术治疗的患者。采用倾向评分匹配（PSM）分析比较MMAE与钻孔引流术的疗效和安全性。疗效指标包括术后90天随访期内的血肿清除率、治愈率、复发率和再次干预率。安全性指标包括术后90天随访时改良Rankin量表（mRS）评分为0 - 2、住院期间与手术相关的并发症以及住院时间。
183例CSDH患者中，34.4%（63例）接受了MMAE，65.6%（120例）接受了钻孔引流手术。与钻孔引流组相比，PSM后MMAE组血肿清除率更高（90.62±8.98% vs. 81.12±18.62%，P = 0.005），治愈率更高（63.4% vs. 41.5%，P = 0.047），复发率更低（2.4% vs. 14.6%，P = 0.048）。MMAE组和钻孔引流组的再次干预率无显著差异（2.4% vs. 7.3%，P = 0.305）。安全性指标有利于MMAE组，术后90天mRS评分更低（0.34±0.53 vs. 0.73±0.55，P = 0.02），住院时间更短（6.41±2.53天 vs. 9.29±3.71天，P < 0.001）。MMAE组4.9%的患者和钻孔引流组9.7%的患者发生了手术相关不良事件（P = 0.392）。
MMAE是一种安全有效的CSDH治疗替代方法，复发率降低。
