Evidence map›Paper›PMID 36348417›Full record

ArticleTrials2022

Swedish trial on embolization of middle meningeal artery versus surgical evacuation in chronic subdural hematoma (SWEMMA)-a national 12-month multi-center randomized controlled superiority trial with parallel group assignment, open treatment allocation and blinded clinical outcome assessment.

Mattias Drake, Teresa Ullberg, Henrietta Nittby, Niklas Marklund, Johan Wassélius

Registry-linked trialOpen access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05267184 (Swedish Trial on Embolization of Middle Meningeal Artery Versus Surgical Evacuation in Chronic Subdural Hematoma), which is not on this map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05267184 narecruitingnot on this map

Swedish Trial on Embolization of Middle Meningeal Artery Versus Surgical Evacuation in Chronic Subdural Hematoma

TypeinterventionalSponsorRegion SkaneRan2022 to 2027Enrolled288ConditionsChronic Subdural HematomaArmsEndovascular treatment of the middle meningeal artery, Standard neurosurgical hematoma evacuation
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 16 citations in OpenAlex.

  1. Review
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  3. Article
  4. Article
  5. N-butyl Cyanoacrylate Use in Various Neuroendovascular Diseases.Journal of neuroendovascular therapy · 2025
    Review
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  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Mattias DrakeDepartment of Imaging and Physiology, Skåne University Hospital, Lund, Sweden. mattias.drake@med.lu.se.ORCID http://orcid.org/0000-0002-2477-572X
Teresa UllbergDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Henrietta NittbyDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Niklas MarklundDepartment of Clinical Sciences Lund, Lund University, Lund, Sweden.
Johan WasséliusDepartment of Imaging and Physiology, Skåne University Hospital, Lund, Sweden.
Lund University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic subdural hematoma (cSDH) is one of the most common neurosurgical disorders and the incidence is rising. The routine treatment is neurosurgical hematoma evacuation, which is associated with recurrence rates up to 10-25%. In recent years, endovascular embolization of the middle meningeal artery (eMMA) has garnered much attention due to recurrence rates as low as < 5%. Several randomized controlled trials are planned or ongoing. In most of these trials, conventional neurosurgical treatment with or without adjunctive endovascular embolization is compared. The proposed trial aims to conduct a head-to-head comparison between neurosurgical and endovascular treatment as stand-alone treatments.

methodsThe trial is academically driven and funded within existing public healthcare systems and infrastructure. Patients with uni- or bilateral cSDH, presenting with mild-to moderate symptoms, and admitted to neurosurgery on clinical grounds will be offered participation. Subjects are randomized 1:1 between conventional neurosurgical treatment (control) and endovascular embolization of the middle meningeal artery (intervention). Primary endpoint is reoperation due to clinically and/or radiologically significant recurrence within 3 months. Secondary endpoints include safety, technical success rate, neurological disability, and quality of life. DISCUSSION: There are mounting retrospective data suggesting eMMA, as sole treatment or as an adjunctive to neurosurgery for cSDH, is safe and effective with a reoperation rate lower than neurosurgical hematoma evacuation alone. If randomized controlled trials confirm these findings, there is a potential for a paradigm shift in the treatment of cSDH where a minimally invasive procedure can replace open surgery in a large and oftentimes old and fragile patient cohort.

trial registrationClinicalTrials.gov, ClinicalTrials.gov Identifier NCT05267184 . Registered March 4, 2022.

Indexed as

Hematoma, Subdural, ChronicHumansMeningeal ArteriesOutcome Assessment, Health CareQuality of LifeRandomized Controlled Trials as TopicRetrospective StudiesSwedenTreatment OutcomeBurr holeChronic subdural hematomaEmbolizationEndovascularMiddle meningeal arteryNeurosurgery

Identifiers

PMID36348417
PMCPMC9641832
OpenAlexW4308592543

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.