Evidence map›Paper›PMID 41495340›Full record

ArticleNeurosurgical review2026

Efficacy of N-butyl-2-cyanoacrylate-based middle meningeal artery embolization for preventing recurrence of chronic subdural hematoma in patients aged 65 years and older.

Yusuke Kitada, Sou Sawamura, Hidetoshi Matsukawa, Hiroto Kakita, Akihiro Kambara, Kohei Tsujino, Daisuke Yamada, Ryo Akiyama, Fuminori Shimizu, Yoshinori Akiyama and 2 more

Abstract read
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In one paragraph

Article in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
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

12 authors.

Yusuke KitadaDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Sou SawamuraDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Hidetoshi MatsukawaDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Hiroto KakitaDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Akihiro KambaraDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Kohei TsujinoDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Daisuke YamadaDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Ryo AkiyamaDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Fuminori ShimizuDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Yoshinori AkiyamaDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Takashi YoshidaDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan.
Nobuyuki SakaiDepartment of Neurosurgery, Shimizu Hospital, 11-2 Nakayoshimi-cho, Yamada, Nishikyo-ku, Kyoto, 615-8276, Japan. n.sakai@siren.ocn.ne.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study evaluated the efficacy and safety of N-butyl-2-cyanoacrylate (NBCA)-based middle meningeal artery embolization (MMAE) in preventing recurrence of chronic subdural hematoma (CSDH) in elderly patients. We retrospectively analyzed 221 patients aged ≥ 65 years who underwent burr hole surgery (BHS) with or without adjunctive MMAE between April 2023 and March 2025. Clinical, radiological, and perioperative variables were assessed, with the primary outcome being 90-day recurrence requiring retreatment. Among the cohort, 92 patients received BHS with MMAE and 129 underwent BHS alone. The median age was 82.0 years (IQR 77.0-86.0), and 64.3% were male. The overall recurrence rate was 12.7% (n = 28). Multivariate analysis identified male sex as an independent risk factor for recurrence (OR 4.95, 95% CI 1.61-21.7, P = 0.004), while acute hemorrhage within the hematoma (OR 0.19, 95% CI 0.01-0.99, P = 0.048) and BHS combined with MMAE (OR 0.37, 95% CI 0.13-0.94, P = 0.04) were associated with reduced recurrence risk. Subgroup analyses suggested that MMAE was particularly effective in male patients and in those with septated hematomas. Additionally, the BHS with MMAE group experienced fewer symptomatic complications (0% vs. 4.6%, P = 0.044) and required postoperative Goreisan far less frequently (16.5% vs. 92.3%, P < 0.001). These findings support that NBCA-based MMAE is associated with lower odds of recurrence and fewer symptomatic complications in elderly patients with CSDH, especially in anatomically and clinically favorable subgroups.

Indexed as

Embolization, TherapeuticEnbucrilateHematoma, Subdural, ChronicMeningeal ArteriesAgedAged, 80 and overFemaleHumansMaleRecurrenceRetrospective StudiesSecondary PreventionTreatment OutcomeEnbucrilateChronic subdural hematomaElderlyMiddle meningeal artery embolizationNBCARecurrence

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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.