Comparison of the efficacy of middle meningeal artery embolization and conventional therapy for chronic subdural hematomas: a propensity score matching study
10.3760/cma.j.cn112149-20210917-00859
- VernacularTitle:脑膜中动脉栓塞与传统方法治疗慢性硬膜下血肿疗效的倾向性评分匹配对比研究
- Author:
Zhensheng LIU
1
;
Demao CAO
;
Yong SUN
;
Tingfeng WEI
;
Xiongwei KUANG
;
Longjiang ZHOU
;
Chenyi WU
;
Hongsheng WANG
Author Information
1. 扬州大学附属医院介入放射科，扬州 225001
- Keywords:
Hematoma, subdural;
Middle meningeal artery;
Angiography;
Embolization
- From:
Chinese Journal of Radiology
2022;56(6):661-666
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effect of middle meningeal artery embolization (MMAE) versus conventional therapy for chronic subdural hematoma (CSDH).Methods:Retrospective analysis of 38 patients with 48 CSDHs treated with MMAE from May 2019 to May 2021 was performed. Comparisons were made with a conventional treatment for 126 patients with 126 CSDHs from January 2016 to May 2021. The MMAE and conventional treatment patients were matched by the propensity score matching method, and a total of 25 pairs of patients (31 pairs of CSDHs) were successfully matched. The CSDH recurrence, rescue treatment, radiographic follow-up outcome, clinical improvement and complication between the two groups were compared by t test, χ 2 test or Fisher exact probability methods. Results:The rescue treatment rate in MMAE group was significantly lower than that in conventional treatment group [0 (0/31) vs 19.4% (6/31), P=0.024] and the complete resolution rate at 6 months follow-up in MMAE group was significantly higher than that in conventional treatment group [96.8 (30/31) vs 74.2% (23/31), P=0.026]. In terms of CSDH recurrence, there was a trend of lower recurrence in the MMAE group [3.2%(1/31) vs 22.6% (7/31), P=0.053]. The complete resolution rate at 3 months follow-up was 61.3% (19/31) in MMAE group and 45.2% (14/31) in conventional treatment, clinical improvement rate was 92.0% (23/25) in MMAE group and 88.0% (22/23) in conventional treatment, good outcome rate (mRS≤2) was 92.0% (23/25) in MMAE group and 84.0% (21/25) in conventional treatment, complication rate was 0(0/25) in MMAE group and 4.0% (1/25) in conventional treatment, and there were no significant differences in all above-mentioned parameters ( P>0.05). Conclusions:The MMAE may be considered as a safe and effective treatment for CSDH, and MMAE for CSDH is associated with lower trend of recurrence, lower rescue treatment rate and better radiographic follow-up outcome than conventional therapy.
