SynthesisActa neurochirurgica2025
Adjunctive middle meningeal artery embolization for non-acute subdural hematoma: A GRADE-assessed meta-analysis and trial sequential analysis on randomized trials.
Synthesis in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of middle meningeal artery embolization for chronic subdural hematoma: an updated systematic review and meta-analysis focusing on time of intervention.Neurosurgical review · 2026Pooled it
- One-and-done middle meningeal artery embolization with next-generation optiblock coils: streamlining workflow for chronic subdural hematoma.Neuroradiology · 2026Article
- Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series.Frontiers in neurology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeNon-acute subdural hematoma (NASDH) is a prevalent neurological condition, encompassing chronic and subacute types. Despite standard-care, including surgical evacuation and medical management, recurrence rates remain high. Emerging evidence suggests that middle meningeal artery embolization (MMAE) as an adjunctive procedure may reduce recurrence. This study evaluates the efficacy and safety of MMAE in NASDH.
methodsA systematic review and meta-analysis of randomized controlled trials (RCTs) retrieved from PubMed, EMBASE, WOS, Scopus, and Cochrane until November 2024. The analysis presented risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI) using R software. The GRADE system assessed evidence certainty, alongside trial sequential analysis for result reliability. PROSPERO ID: CRD42024625504.
resultsSix RCTs and 1,544 patients were included, with an average of 4.7 months follow-up. Adjunctive MMAE, compared to standard-care, significantly reduced hematoma recurrence (8% vs 15.6%; RR: 0.52; 95% CI: [0.37:0.73]; P < 0.01) and surgical rescue (4.5% vs. 12.7%; RR: 0.36; 95% CI: [0.25:0.53]; P < 0.01). However, no significant effect was found for recurrence without surgery (P = 0.94), hematoma volume (P = 0.18), thickness (P = 0.34), or hospital stay (P = 0.37). Infection rates were higher with MMAE (8.4% vs. 4.8%; RR: 1.81; 95% CI: [1.23:2.66]; P < 0.01), but adverse events (AEs), serious AEs, intracranial hemorrhage, stroke, and mortality showed no significant differences.
conclusionAdjunctive MMAE reduced hematoma recurrence and surgical rescue rates in NASDH with an acceptable safety profile despite increased infection rates. However, further large-scale trials with extended follow-ups are needed.
Indexed as
Identifiers
What OpenQuestion holds
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.