Evidence map›Paper›PMID 42274749›Full record

ArticleClinical neuroradiology2026

Real-World Safety Profile of Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: a Multinational Multicenter Study.

Bluyé DeMessie, Alireza Karandish, Muhammed Amir Essibayi, Hamza Adel Salim, Deepak Khatri, Neil Haranhalli, Amanda Baker, Richard Zampolin, Allan L Brook, Seon-Kyu Lee and 86 more

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Article in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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96 authors.

Bluyé DeMessieDepartments of Neurological Surgery and Radiology, Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Alireza KarandishDepartments of Neurological Surgery and Radiology, Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Muhammed Amir EssibayiDepartments of Neurological Surgery and Radiology, Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States. m.amir.essibayi@gmail.com.
Hamza Adel SalimDepartment of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, United States.
Deepak KhatriDepartment of Neurological Surgery and Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Neil HaranhalliDepartment of Neurological Surgery and Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Amanda BakerDepartment of Neurological Surgery and Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Richard ZampolinDepartment of Neurological Surgery and Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Allan L BrookDepartment of Neurological Surgery and Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Seon-Kyu LeeDepartment of Neurological Surgery and Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.
Nimer AdeebDepartment of Neurosurgery, Ochsner-Louisiana State University, Shreveport, United States.
Dhairya A LakhaniDepartment of Neuroradiology, Rockefeller Neuroscience Institute, Western Virginia University, Morgantown, United States.
Yan-Lin LiNuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
Diego Alejandro OrtegaNeurovascular Centre & RADIS Lab, St. Michael's Hospital, Toronto, Canada.
Nicole CancelliereNeurovascular Centre & RADIS Lab, St. Michael's Hospital, Toronto, Canada.
Jose Danilo DiestroNeurovascular Centre & RADIS Lab, St. Michael's Hospital, Toronto, Canada.
Joseph CarnevaleDepartment of Neurological Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, United States.
Craig SchreiberDepartment of Neurological Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, United States.
Atakan OrscelikDepartment of Neurological Surgery and Radiology, Mayo Clinic, Rochester, United States.
Zachary AbecassisDepartment of Neurological Surgery, University of Washington, Seattle, United States.
Spencer RaubDepartment of Neurological Surgery, University of Washington, Seattle, United States.
Georgios S SioutasDepartment of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, United States.
Abdulrhman AlsalamaDepartment of Neurosurgery, University of Illinois at Chicago, Chicago, United States.
Clairice PearceDepartment of Neurosurgery, University of Illinois at Chicago, Chicago, United States.
Giancarlo SalsanoDepartment of Neuroradiology and Neurosurgery, Interventional Neuroradiology Division, San Raffaele University Hospital, Milan, Italy.
Rahim Abo KasemDepartment of Neurology and Neurosurgery, Medical University of South Carolina, Charleston, United States.
Svetlana KvintDepartment of Radiology and Neurosurgery, New York University Langone Medical Center, New York, United States.
Andrew FalzonDepartment of Radiology and Neurosurgery, St George's, University of London, London, United Kingdom.
Vance CantrellDepartment of Radiology, Interventional Neuroradiology, Lehigh Valley Health Network, Allentown, United States.
Brian HollidayDepartment of Radiology, Interventional Neuroradiology, Lehigh Valley Health Network, Allentown, United States.
Jefferson O AbariciaDepartment of Interventional Radiology and Neurosurgery, Oregon Health and Science University Hospital, Portland, United States.
Pedram MalekniaUniversity of Alabama at Birmingham, Birmingham, United States.
Leonardo Cruz-CriolloDepartment of Neurology, Neurosurgery & Radiology, University of Iowa Hospitals and Clinics, Iowa City, United States.
Samantha SchimmelDepartment of Neurosurgery & Brain Repair, University of South Florida, Tampa, United States.
Basel MusmarDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia, United States.
Matthew AlexanderNeurointerventional Surgery, Sutter Sacramento Medical Center, Sacramento, United States.
Jorge Rios ZermenoDepartment of Neurological Surgery and Radiology, Mayo Clinic Florida, Jacksonville, United States.
Koul PrateekaDepartment of Neurosurgery, Geisinger, Wilkes-Barre, United States.
Ahmed AljubooriDepartment of Neurosurgery, Geisinger, Wilkes-Barre, United States.
Dominik F VollherbstDepartment of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.
Domagoj GajskiDepartment of Neurosurgery, Sisters of Charity Hospital, Zagreb, Croatia.
Jared CooperDepartment of Neurosurgery, Westchester Medical Center, Valhalla, United States.
Omar AlwakaaNeurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.
Mohamad EzzeldinNeuro endovascular surgery, HCA Houston Healthcare Kingwood, Houston, United States.
James GristNuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
Fulvio ZaccagnaNuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
Christopher S OgilvyNeurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States.
Fawaz Al-MuftiDepartment of Neurosurgery, Westchester Medical Center, Valhalla, United States.
Vladimir KalousekDepartment of Neurosurgery, Sisters of Charity Hospital, Zagreb, Croatia.
Markus A MöhlenbruchDepartment of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.
Luca ScarciaDepartment of Neuroradiology, Hôpitaux Universitaires Henri-Mondor, Créteil, France.
William W WroeDepartment of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, United States.
Hussein A ZeineddineDepartment of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, United States.
Tang Si ZhaoDivision of Interventional Radiology, Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore.
Peter B SpornsDepartment of Neuroradiology, University Hospital of Basel, Basel, Switzerland.
Anil GopinathanDivision of Interventional Radiology, Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore.
Robert W RegenhardtDepartment of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, United States.
Spiros L BlackburnDepartment of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, United States.
Clemens M SchirmerDepartment of Neurosurgery, Geisinger, Wilkes-Barre, United States.
Thien HuynhDepartment of Neurological Surgery and Radiology, Mayo Clinic Florida, Jacksonville, United States.
Rabih TawkDepartment of Neurological Surgery and Radiology, Mayo Clinic Florida, Jacksonville, United States.
Fabio SettecaseNeurointerventional Surgery, Sutter Health California Pacific Medical Center, San Francisco, United States.
Stavropoula TjoumakarisDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia, United States.
Pascal JabbourDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia, United States.
Kunal VakhariaDepartment of Neurosurgery & Brain Repair, University of South Florida, Tampa, United States.
Mario ZanatyDepartment of Neurology, Neurosurgery & Radiology, University of Iowa Hospitals and Clinics, Iowa City, United States.
Santiago Ortega-GutierrezDepartment of Neurology, Neurosurgery & Radiology, University of Iowa Hospitals and Clinics, Iowa City, United States.
Jesse G JonesUniversity of Alabama at Birmingham, Birmingham, United States.
Marco ColasurdoDepartment of Interventional Radiology and Neurosurgery, Oregon Health and Science University Hospital, Portland, United States.
Hussein H NasserDepartment of Radiology, Interventional Neuroradiology, Lehigh Valley Health Network, Allentown, United States.
Sri Hari SundararajanDepartment of Radiology, Interventional Neuroradiology, Lehigh Valley Health Network, Allentown, United States.
Pascal J MosimannInterventional and Diagnostic Neuroradiology, Toronto Western Hospital, Toronto, Canada.
Erez NossekDepartment of Radiology and Neurosurgery, New York University Langone Medical Center, New York, United States.
Eytan RazDepartment of Radiology and Neurosurgery, New York University Langone Medical Center, New York, United States.
Sami Al KasabDepartment of Neurology and Neurosurgery, Medical University of South Carolina, Charleston, United States.
Alejandro M SpiottaDepartment of Neurology and Neurosurgery, Medical University of South Carolina, Charleston, United States.
Lucio CastellanUnit of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Bruno Del SetteUnit of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Ali AlarajDepartment of Neurosurgery, University of Illinois at Chicago, Chicago, United States.
Caterina MichelozziDepartment of Neuroradiology and Neurosurgery, Interventional Neuroradiology Division, San Raffaele University Hospital, Milan, Italy.
Davide SaracenoDepartment of Neuroradiology and Neurosurgery, Interventional Neuroradiology Division, San Raffaele University Hospital, Milan, Italy.
Pietro PanniDepartment of Neuroradiology and Neurosurgery, Interventional Neuroradiology Division, San Raffaele University Hospital, Milan, Italy.
Visish M SrinivasanDepartment of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, United States.
Jan-Karl BurkhardtDepartment of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, United States.
Gaultier MarnatNeuroradiology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Pietro Mario SantiniNeuroradiology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Michael R LevittDepartment of Neurological Surgery, University of Washington, Seattle, United States.
Giuseppe LanzinoDepartment of Neurological Surgery and Radiology, Mayo Clinic, Rochester, United States.
Jared KnopmanDepartment of Neurological Surgery, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, United States.
Tareq Kass-HoutDepartment of Neurology, University of Chicago, Chicago, United States.
Julian SpearsNeurovascular Centre & RADIS Lab, St. Michael's Hospital, Toronto, Canada.
Thomas MarottaNeurovascular Centre & RADIS Lab, St. Michael's Hospital, Toronto, Canada.
Vitor Mendes PereiraNeurovascular Centre & RADIS Lab, St. Michael's Hospital, Toronto, Canada.
Tufail PatankarDepartment of Neuroradiology, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, United Kingdom.
Adam A DmytriwNuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
David J AltschulDepartments of Neurological Surgery and Radiology, Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMiddle meningeal artery embolization (MMAE) has emerged as a treatment for chronic subdural hematoma (cSDH), but comprehensive real-world safety data remain limited.

methodsWe performed a multicenter retrospective analysis of 1781 consecutive patients undergoing MMAE for cSDH (2019-2025). The primary outcome was any procedure-related complication within 30 days. Inverse probability of treatment weighting (IPTW) assessed the association between technical success and complications, adjusting for demographic, clinical, and procedural confounders.

resultsMean age was 72.8 ± 12.4 years; 68.1% were male. The 30-day complication rate was 5.1% (91/1781; 95% CI, 4.1-6.2). In-hospital mortality was 2.9% (47/1625). Technical success was achieved in 97.5% (1505/1543). Among documented complications, thromboembolic events were most common (37.2%; 32/86), followed by hemorrhagic complications (23.8%; 20/84) and access-site hematoma (10.4%; 8/77). Among patients with classifiable symptom status, 80.6% of complications were symptomatic, yielding an overall symptomatic complication rate of 3.0%. Neurological deterioration occurred in 27.1% (248/915). Among 1552 patients with documented surgical approach, complication rates were similar between surgery plus embolization (4.9%; 34/690) and embolization alone (5.2%; 45/860; OR, 0.94; 95% CI, 0.59-1.48; p = 0.79). After IPTW adjustment, technical success was associated with an 86% reduction in complication odds (OR, 0.14; 95% CI, 0.05-0.40; p < 0.001).

conclusionsIn this large multicenter cohort, MMAE was associated with a 5.1% complication rate. Technical success was the strongest protective factor. Embolization with or without surgery showed equivalent safety profiles.

Indexed as

Chronic subdural hematomaComplicationsMiddle meningeal artery embolizationSafety

Identifiers

PMID42274749

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