Abstract
Objective
To preliminarily conclude the safety and efficacy of middle meningeal artery embolization (MMAE) with Glubran 2 in treating chronic subdural hematoma (CSDH).
Methods
This retrospective analysis was performed on 40 consecutive CSDH patients who received MMAE with Glubran 2 between 2021 and 2023. The patients were followed up for 3 years post-operationally. Surgical procedures included burr hole drainage (BHD) and MMAE, both of which were performed under local anesthesia. MMAE with Glubran 2 was performed through transfemoral access. Postoperative recurrence was defined as an increase in hematoma volume based on computed tomography (CT) and/or magnetic resonance imaging (MRI) accompanied by clinical symptoms, which require further treatment within 3 years postoperatively.
Results
In this study, 40 CSDH patients (34 male and six female) with a mean age of 68.2 ± 13.2 years were included. Of these, 38 patients underwent MMAE-assisted BHD. Two patients received MMAE alone. A single-branch embolization was performed on 20 hematomas in 18 patients, and a double-branch on 27 hematomas in 22 patients. At the three-year follow-up, 33 patients were successfully contacted, and 24 patients showed significant improvement or were asymptomatic after treatment. Three patients passed away owing to non-CSDH-related reasons. One patient developed decompensated liver cirrhosis, one experienced Alzheimer's disease, and four patients experiencing deteriorated functions were unclear but non-CSDH related as demonstrated by absorbed hematomas on head CT or MRI during return visits. The median follow-up time was 35 (IQR 27–40) months, and the median mRS score was 0 (IQR 0-0).
Conclusion
MMAE-assisted BHD with Glubran 2 is feasible, safe, and effective in treating CSDH, with no associated complications.
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