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Journal article
Radiographic and clinical outcomes with particle or liquid embolic agents for middle meningeal artery embolization of nonacute subdural hematomas
Interventional neuroradiology, pp 159101992211046-15910199221104631
07 Jun 2022
PMID: 35673710
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Middle meningeal artery (MMA) embolization is an apparently efficacious minimally invasive treatment for nonacute subdural hematomas (NASHs), but how different embolisates affect outcomes remains unclear. Our objective was to compare radiographic and clinical outcomes after particle or liquid MMA embolization. Methods Patients who had MMA embolization for NASH were retrospectively identified from a multi-institution database. The primary radiographic and clinical outcomes—50% NASH thickness reduction and need for surgical retreatment within 90 days, respectively—were compared for liquid and particle embolizations in patients treated 1) without surgical intervention (upfront), 2) after recurrence, or 3) with concomitant surgery (prophylactic). Results The upfront, recurrent, and prophylactic subgroups included 133, 59, and 16 patients, respectively. The primary radiographic outcome was observed in 61.8%, 61%, and 72.7% of particle-embolized patients and 61.3%, 55.6%, and 20% of liquid-embolized patients, respectively (p = 0.457, 0.819, 0.755). Hazard ratios comparing time to reach radiographic outcome in the particle and liquid groups or upfront, recurrent, andprophylactic timing were 1.31 (95% CI 0.78–2.18; p = 0.310), 1.09 (95% CI 0.52–2.27; p = 0.822), and 1.5 (95% CI 0.14–16.54; p = 0.74), respectively. The primary clinical outcome occurred in 8.0%, 2.4%, and 0% of patients who underwent particle embolization in the upfront, recurrent, and prophylactic groups, respectively, compared with 0%, 5.6%, and 0% who underwent liquid embolization (p = 0.197, 0.521, 1.00). Conclusions MMA embolization with particle and liquid embolisates appears to be equally effective in treatment of NASHs as determined by the percentage who reach, and the time to reach, 50% NASH thickness reduction and the incidence of surgical reintervention within 90 days.
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Details
- Title
- Radiographic and clinical outcomes with particle or liquid embolic agents for middle meningeal artery embolization of nonacute subdural hematomas
- Creators
- Jonathan P. Scoville - University of UtahEvan Joyce - University of UtahDaniel A. Tonetti - Cooper Neuroscience Institute, Camden, New Jersey, USAMichael T. Bounajem - University of UtahAjith Thomas - Beth Israel Deaconess Medical CenterChristopher S. Ogilvy - Beth Israel Deaconess Medical CenterJustin M. Moore - Beth Israel Deaconess Medical CenterHoward A. Riina - New York University Langone Medical CenterOmar Tanweer - Baylor College of MedicineElad I. Levy - University at Buffalo, State University of New YorkAlejandro M. Spiotta - Medical University of South CarolinaBradley A. Gross - University of Pittsburgh Medical CenterBrian T. Jankowitz - Cooper Neuroscience Institute, Camden, New Jersey, USAC. Michael Cawley - Emory UniversityAlexander A. Khalessi - University of California, San DiegoAditya S. Pandey - University of Michigan–Ann ArborAndrew J. Ringer - Good Samaritan HospitalRicardo Hanel - Baptist Medical Center JacksonvilleRafael A. Ortiz - Lenox Hill HospitalDavid Langer - Lenox Hill HospitalMichael R. Levitt - Harborview Medical CenterMandy Binning - Drexel UniversityPhilipp Taussky - University of UtahPeter Kan - The University of Texas Medical Branch at GalvestonRamesh Grandhi - University of Utah
- Publication Details
- Interventional neuroradiology, pp 159101992211046-15910199221104631
- Publisher
- Sage
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000810883900001
- Scopus ID
- 2-s2.0-85131738776
- Other Identifier
- 991019169811404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Radiology, Nuclear Medicine & Medical Imaging