ArticleNeuroradiology2026
Longitudinal hematoma resolution after burr-hole evacuation with adjunctive scepter mini-assisted middle meningeal artery embolization: A multicenter matched cohort study.
Article in 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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Abstract
objectivesTo evaluate the radiographic and clinical outcomes of adjunctive middle meningeal artery embolization (MMAE) performed with the Scepter Mini dual-lumen balloon microcatheter following burr-hole evacuation for chronic subdural hematoma (cSDH), and to explore the feasibility of characterizing distal embolic penetration using the proposed MMA Embolization Penetration Score (MMA-EPS).
methodsThis retrospective multicenter matched cohort study included consecutive patients with cSDH treated with burr-hole evacuation followed by adjunctive MMAE using the Scepter Mini and Onyx™ 18. A matched historical cohort treated with burr-hole evacuation alone served as controls. The primary endpoint was longitudinal hematoma thickness regression on serial computed tomography. Secondary endpoints included functional outcome, recurrence, all-cause mortality, and procedural safety.
resultsTwenty-two patients with 38 embolized cSDHs were compared with 22 matched controls comprising 38 cSDHs. All embolized hematomas achieved MMA-EPS Grade 3 or 4 and demonstrated complete radiographic resolution by 6 months, whereas residual hematoma persisted in controls (0.0 ± 0.0 vs. 0.7 ± 0.9 mm). Favorable functional outcome (mRS 0-2) at 6 months was achieved in 86.4% versus 45.5% of patients. Exploratory analyses showed numerically lower recurrence (4.5% vs. 13.6%) and all-cause mortality (0% vs. 13.6%) following MMAE; however, the study was not powered to assess differences in these endpoints. Technical success was achieved in all embolizations without major procedure-related complications.
conclusionAdjunctive MMAE using the Scepter Mini dual-lumen balloon microcatheter was associated with accelerated hematoma resolution, improved functional recovery, and an excellent procedural safety profile compared with burr-hole evacuation alone.
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