Evidence map›Paper›PMID 40824387›Full record

ArticleClinical neuroradiology2026

Middle Meningeal Artery Embolization for the Treatment of Chronic Subdural Hematomas-a German Nationwide Multi-center Study On 718 Embolizations.

Dominik F Vollherbst, Ansgar Berlis, Mahmoud Zaki, Christoph Maurer, Christina Onyinzo, Fee C Keil, Leonard Mann, Christophe T Arendt, Marius Hartmann, Steffen Reißberg and 46 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Review
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

56 authors.

Dominik F VollherbstDepartment of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany. dominik.vollherbst@med.uni-heidelberg.de.ORCID http://orcid.org/0000-0002-8992-4757
Ansgar BerlisDiagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany.
Mahmoud ZakiDiagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany.
Christoph MaurerDiagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany.
Christina OnyinzoNeurosurgery, Schön Klinik Vogtareuth, Vogtareuth, Germany.
Fee C KeilInstitute of Neuroradiology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.
Leonard MannInstitute of Neuroradiology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.
Christophe T ArendtInstitute of Neuroradiology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.
Marius HartmannInstitut für Neuroradiologie, Helios Klinikum Berlin-Buch, Berlin, Germany.
Steffen ReißbergInstitut für Neuroradiologie, Helios Klinikum Berlin-Buch, Berlin, Germany.
Corinna RutschkeInstitut für Neuroradiologie, Helios Klinikum Berlin-Buch, Berlin, Germany.
Kai KallenbergDepartment of Neuroradiology, Klinikum Fulda, Fulda, Germany.
Stefan GrauClinic for Neurosurgery, Klinikum Fulda, Fulda, Germany.
Alexandru DurutyaDepartment of Neuroradiology, Klinikum Fulda, Fulda, Germany.
Adrian LiebertDepartment of Neurosurgery, Paracelsus Medical University, Nuremberg, Germany.
Heinz L Voit-HöhneDepartment of Neuroradiology, Paracelsus Medical University, Nuremberg, Germany.
Markus HoltmannspötterDepartment of Neuroradiology, Paracelsus Medical University, Nuremberg, Germany.
Christian HerwehDepartment of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.
René ChapotNeuroradiology, Alfried-Krupp-Krankenhaus Rüttenscheid, Essen, Germany.
Mohamed ElsharkawyNeuroradiology, Alfried-Krupp-Krankenhaus Rüttenscheid, Essen, Germany.
Dan MeilaDepartment of Interventional Neuroradiology, Johanna-Etienne-Hospital, Neuss, Germany.
Björn GrelingDepartment of Interventional Neuroradiology, Johanna-Etienne-Hospital, Neuss, Germany.
Frederik BoxbergDepartment of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
Dominik GriebDepartment of Radiology and Neuroradiology, Sana Kliniken Duisburg, Duisburg, Germany.
Cornelius DeuschlInstitute for Diagnostic and Interventional Radiology and Neuroradiology, University Medicine Essen, University of Duisburg-Essen, Essen, Germany.
Yahya AhmadipourDepartment of Neurosurgery and Spine Surgery, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, University Duisburg-Essen, Essen, Germany.
Tobias Boeckh-BehrensSchool of Medicine and Health, Institute for Neuroradiology, TUM University Hospital, Technical University of Munich, Munich, Germany.
Jannis BoddenSchool of Medicine and Health, Institute for Neuroradiology, TUM University Hospital, Technical University of Munich, Munich, Germany.
Carsten LukasInstitute of Neuroradiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
Felix KämmererInstitute of Neuroradiology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
Daniel BehmeClinic for Neuroradiology, University Medical Center Magdeburg, Magdeburg, Germany.
Elie DiamandisClinic for Neuroradiology, University Medical Center Magdeburg, Magdeburg, Germany.
Eberhard SiebertInstitute of Neuroradiology, Charité, Universitätsmedizin Berlin, Berlin, Germany.
Aymen MeddebInstitute of Neuroradiology, Charité, Universitätsmedizin Berlin, Berlin, Germany.
Kornelia KreiserDepartment of Neuroradiology, University of Ulm, Ulm, Germany.
Sabine HeinzDepartment of Neuroradiology, University of Ulm, Ulm, Germany.
Stephan MeckelInstitute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany.
Semin Berzeg-KolckInstitute of Diagnostic and Interventional Neuroradiology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany.
Jens FiehlerKlinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Matthias BechsteinKlinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Marius G KaschnerDepartment of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany.
Keihan DarvishiDepartment of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany.
Laura S LeukertDepartment of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany.
Marc A BrockmannDepartment of Neuroradiology, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany.
Thomas E MayerSektion Neuroradiologie, Institut für diagnostische und interventionelle Radiologie, Universitätsklinikum Jena, Jena, Germany.
Jan-Hendrik BuhkNeuroradiology, Asklepios Klinik St. Georg, Hamburg, Germany.
Charlotte S WeylandDepartment of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany.
Lukas GörtzDepartment of Radiology and Neuroradiology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Christoph KabbaschDepartment of Radiology and Neuroradiology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Werner WeberInstitut für Diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Knappschaft Kliniken, Universitätsklinikum Bochum, Bochum, Germany.
Christina WendlDepartment of Radiology, University Medical Center Regensburg, Regensburg, Germany.
Tobias StruffertDepartment of Neuroradiology, University Hospital Giessen, Giessen, Germany.
Christian DyzmannNeuroradiology Department, Sana Kliniken, Lübeck, Germany.
Johannes C GerberInstitute of Neuroradiology, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany.
Martin BendszusDepartment of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.
Markus A MöhlenbruchDepartment of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmbolization of the middle meningeal artery (EMMA) is a promising novel technique for the treatment of patients with chronic subdural hematomas (cSDH).

methodsAfter a nationwide query in Germany, patients with cSDH, treated with EMMA were retrospectively analyzed. Patient and cSDH characteristics, procedural parameters, complications, and rates of treatment failure (TF; residual cSDH > 10 mm, cSDH progression or requirement of rescue surgery) were investigated. TF rates were compared between first-time treatments and treatments of recurrent cSDH, patients receiving embolization and surgery and those being embolized only, different types of embolic agents (particles vs. liquid agents) and between patients with and without antithrombotic medication.

results718 EMMAs (420 unilateral, 149 bilateral) were performed in 569 patients in 30 German neurovascular centers. 57.1% were first-time treatments and 42.9% were treatments of recurrent cSDHs. The most frequently used embolic agents were particles (56.2%), followed by copolymer-based liquid embolic agents (19.6%). The rate of symptomatic procedure-related complications was 2.5%. After a mean follow-up of 6.5 months, TF was observed in 16.2% across all treatments and was more frequent after the treatment of recurrent cSDHs (19.8% vs. 13.5%, p = 0.045) and in patients taking antithrombotic drugs (17.7% vs. 11.5%; p = 0.044). TF was not significantly different regarding the type of embolic agent or additional surgery.

conclusionsIn this nationwide multi-center study, EMMA was associated with favorable clinical outcomes and a low complication rate, supporting the results of recently published randomized controlled trials. TF was more frequent in recurrent cSDH treatments and in patients taking antithrombotic drugs.

Indexed as

Embolization, TherapeuticHematoma, Subdural, ChronicMeningeal ArteriesAgedAged, 80 and overFemaleGermanyHumansMaleMiddle AgedRecurrenceRetrospective StudiesTreatment OutcomeChronic subdural hematomaChronic subdural hemorrhageEmbolizationMiddle meningeal artery

Identifiers

PMID40824387
PMCPMC13009104

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Registered trials

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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.