SynthesisNeurosurgical review2025
Comparison of middle meningeal artery embolization alone, in combination with surgery, and surgery alone for chronic subdural hematoma: a network meta-analysis of 143,590 patients.
Synthesis in Neurosurgical review, 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
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic subdural hematoma (cSDH) is associated with high recurrence following surgical evacuation. Middle meningeal artery embolization (MMAE) has emerged as a minimally invasive alternative or adjunct to surgery. This study aimed to compare the clinical effectiveness of standalone MMAE, adjunct MMAE, and surgical drainage alone for managing cSDH. A systematic review was conducted across major databases. Outcomes of interest included recurrence, rescue surgery, hematoma resolution, complications, functional outcome (mRS > 2), hospital stay, and mortality. Following screening, thirty-four studies (6 randomized trials) comprising 143,590 patients were included. A Bayesian network meta-analysis (NMA) was conducted on extracted data. Both standalone and adjunct MMAE reduced recurrence (OR = 0.12, 0.28, respectively) and need for rescue surgery (OR = 0.36, 0.37, respectively) compared to surgery alone in Bayesian NMA. Baseline characteristics were largely comparable across groups. While pairwise analysis showed standalone MMAE associated with greater hematoma reduction (OR = 1.46) and fewer complications (OR = 0.79), Bayesian NMA showed no significant difference. No significant differences were found in functional outcome, resolution, hospital stay, or mortality. Subgroup analysis on randomized trials confirmed adjunct MMAE reduced rescue surgery (P < 0.001) but not recurrence (P = 0.53). Both standalone and adjunctive MMAE reduce recurrence risk in cSDH compared to surgery alone. Standalone MMAE reduces complications and hematoma volume, making it suitable for nonsurgical candidates or smaller hematomas. Adjunct MMAE is effective in reducing reintervention risk and may be preferred when immediate surgical evacuation is necessary. MMAE, as a standalone or combined approach, represents a valuable strategy in cSDH management that helps minimize recurrence.
Indexed as
Identifiers
40830677What 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.