SynthesisNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025
Surgical evacuation without versus with middle meningeal artery embolization in chronic subdural hematoma: A meta-analysis of randomized controlled trials.
Synthesis in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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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
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis meta-analysis evaluates the efficacy and safety of middle meningeal artery embolization (MMAE) combined with surgery versus surgery alone in chronic subdural hematoma (CSDH).
methodsWe systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) comparing MMAE combined with surgery to surgery alone. And outcomes were pooled using a random-effects model. Primary efficacy outcome was treatment failure (recurrence or reoperation). Trial sequential analysis (TSA) employed to assess the robustness of the evidence for treatment failure. Primary safety outcomes included serious adverse events. Secondary efficacy outcomes included changes in hematoma volume, hematoma thickness, and functional independence (modified Rankin Scale [mRS] 0-2). Secondary safety outcome was all-cause mortality.
resultsA total of six RCTs, involving 1,222 patients, were included in the analysis. MMAE combined with surgery significantly reduced treatment failure risk (RR 0.56, 95% CI 0.35-0.89, P = 0.02) compared to surgery alone. In the TSA, the cumulative z-line crossed the boundary for effect. No significant differences were observed in serious adverse events (RR 1.10, 95% CI 0.84-1.44), changes in hematoma volume (MD -7.19; 95% CI, -25.25-10.86; P = 0.43), change in hematoma thickness (MD 0.08; 95% CI, -1.00-1.15; P = 0.89) or mortality (RR 1.52, 95% CI 0.81-2.85; P= 0.19).
conclusionsMMAE, as an adjunct to surgery, reduces the risk of treatment failure in CSDH without compromising safety outcomes, but further trials are needed for validation.
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Identifiers
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Registered trials
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