Evidence map›Paper›PMID 42103984›Full record

ArticleNeurosurgical review2026

Reinitiating antiplatelet therapy in chronic subdural hematoma: Does adjunctive middle meningeal artery embolization improve outcomes?

Muhammed Amir Essibayi, Jay Kakadiya, Hamza Adel Salim, Huanwen Chen, Ahmed Y Azzam, Adam A Dmytriw, Vivek S Yedavalli, Mohammad A Kassar, Marco Colasurdo, Dheeraj Gandhi and 4 more

Abstract read
PubMed Full text at PMC Publisher
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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Muhammed Amir EssibayiDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. m.amir.essibayi@gmail.com.
Jay KakadiyaDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Hamza Adel SalimDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Huanwen ChenDivision of Neurointerventional Surgery, Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA.
Ahmed Y AzzamDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Adam A DmytriwNuffield Department of Surgical Sciences, Faculty of Clinical Medicine, University of Oxford, Oxford, UK.
Vivek S YedavalliDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Mohammad A KassarDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Marco ColasurdoDepartment of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA.
Dheeraj GandhiDivision of Neurointerventional Surgery, Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA.
Deepak KhatriDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Neil HaranhalliDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
David J AltschulDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Sally Lynn Hodder · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

The optimal timing for reinitiating antiplatelet therapy after treatment of chronic subdural hematoma (cSDH) remains uncertain, especially when middle meningeal artery embolization (MMAE) is used as an adjunct to surgery. This study evaluated the safety and outcomes of early antiplatelet reinitiation in patients undergoing combined surgical evacuation and MMAE, and compared outcomes in antiplatelet-treated patients receiving surgery with versus without MMAE. Adult cSDH patients from the TriNetX database (May 2020-May 2025) were identified using ICD-10 and RXNORM codes. Two propensity score-matched analyses were performed: (1) patients receiving surgery with adjunct MMAE, stratified by antiplatelet initiation within 30 days; and (2) antiplatelet-treated patients undergoing surgery with adjunct MMAE versus surgery alone. Outcomes included rescue surgery and 6-month mortality. After matching, early antiplatelet use in surgery + MMAE patients (n = 163 per group) was not associated with higher rescue surgery rates (OR 0.68, 95% CI 0.32-1.48) or mortality (OR 1.52, 95% CI 0.73-3.20). Among antiplatelet-treated patients, surgery + MMAE (n = 176) had similar rescue surgery rates to surgery alone (n = 176) but significantly lower mortality (10.8% vs. 21.0%; OR 0.46, 95% CI 0.25-0.83, p = 0.009). Early antiplatelet reinitiation appeared safe after cSDH evacuation with adjunct MMAE. The associated lower 6-month mortality with adjunct MMAE in antiplatelet-treated patients is observational and hypothesis-generating, and warrants prospective confirmation.

Indexed as

Embolization, TherapeuticHematoma, Subdural, ChronicMeningeal ArteriesPlatelet Aggregation InhibitorsAgedAged, 80 and overCombined Modality TherapyFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomePlatelet Aggregation InhibitorsChronicEmbolizationHematomaMeningeal arteriesPlatelet aggregation inhibitorsSubduralTherapeuticTreatment outcome

Identifiers

PMID42103984
PMCPMC13156191

What OpenQuestion holds

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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.