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Middle meningeal artery embolization with subdural evacuating port system for primary management of chronic subdural hematomas.

MedStar author(s):

Citation: Neurosurgical Review. 45(1):439-449, 2022 Feb.PMID: 33893872Institution: MedStar Medical Group | MedStar Washington Hospital CenterDepartment: Neurosurgery | Neurosurgery Residency | RadiologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Embolization, Therapeutic | *Hematoma, Subdural, Chronic | Hematoma, Subdural, Chronic/su [Surgery] | Humans | Meningeal Arteries | Retrospective Studies | Subdural SpaceYear: 2022 ISSN:

0344-5607

Name of journal: Neurosurgical reviewAbstract: Optimal treatment for chronic subdural hematomas remains controversial and perioperative risks and comorbidities may affect management strategies. Minimally invasive procedures are emerging as alternatives to the standard operative treatments. We evaluate our experience with middle meningeal artery (MMA) embolization combined with Subdural Evacuating Port System (SEPS) placement as a first-line treatment for patients with cSDH. A single institution retrospective review was performed of all patients undergoing intervention. Patients were stratified by treatment with MMA embolization and SEPS placement, MMA embolization and surgery, SEPS placement only, and surgery only for cSDH from 2017 to 2020, and cohorts were compared against each other. Patients treated with MMA/SEPS were more likely to be older, be on anticoagulation, have significant comorbidities, have shorter length of stay, and less likely to have symptomatic recurrence compared to SEPS only cohort. Thus, MMA/SEPS appears to be a safe and equally effective minimally invasive treatment for cSDH patients with significant comorbidities who are poor surgical candidates.All authors: Armonda RA, Carpenter A, Dowlati E, Felbaum DR, Liu AH, Mai JC, Miller C, Rock MOriginally published: Neurosurgical Review. 2021 Apr 24Fiscal year: FY202Fiscal year of original publication: FY2021Digital Object Identifier:

https://dx.doi.org/10.1007/s10143-021-01553-x

ORCID:

http://orcid.org/0000-0001-6739-0793

Date added to catalog: 2021-06-07

Holdings ( 1 )
Title notes ( 2 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33893872	Available		33893872

Optimal treatment for chronic subdural hematomas remains controversial and perioperative risks and comorbidities may affect management strategies. Minimally invasive procedures are emerging as alternatives to the standard operative treatments. We evaluate our experience with middle meningeal artery (MMA) embolization combined with Subdural Evacuating Port System (SEPS) placement as a first-line treatment for patients with cSDH. A single institution retrospective review was performed of all patients undergoing intervention. Patients were stratified by treatment with MMA embolization and SEPS placement, MMA embolization and surgery, SEPS placement only, and surgery only for cSDH from 2017 to 2020, and cohorts were compared against each other. Patients treated with MMA/SEPS were more likely to be older, be on anticoagulation, have significant comorbidities, have shorter length of stay, and less likely to have symptomatic recurrence compared to SEPS only cohort. Thus, MMA/SEPS appears to be a safe and equally effective minimally invasive treatment for cSDH patients with significant comorbidities who are poor surgical candidates.

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