Middle meningeal artery embolization for chronic subdural hematoma complications
The reported complication rate among patients who undergo Middle meningeal artery embolization for cSDH is low 1)
The two largest series, those of Link et al. 2) (N = 49 patients) and Ban et al. 3) (N = 72 patients), reported no procedural complications attributable to MMA embolization. The recently published meta-analysis by Srivatsan et al. 4) analyzed three different double-arm studies comparing embolization and conventional surgery. The authors found a complication rate of 2% in the embolization group vs. 4% in the conventional surgical group 5)
The pooled recurrence, surgical rescue, and in-hospital complication rates in the MMA embolization cohort were 4.8% (95% CI 3.2% to 6.5%), 4.4% (2.8% to 5.9%), and 1.7% (0.8% to 2.6%), respectively. The pooled recurrence, surgical rescue, and in-hospital complication rates in the conventional management cohort were 21.5% (0.6% to 42.4%), 16.4% (5.9% to 27.0%), and 4.9% (2.8% to 7.1%), respectively. Compared with conservative management, MMA embolization was associated with lower rates of cSDH recurrence (OR=0.15 (95% CI 0.03 to 0.75), p=0.02) and surgical rescue (OR=0.21 (0.07 to 0.58), p=0.003). In-hospital complication rates were comparable between the two cohorts (OR=0.78 (0.34 to 1.76), p=0.55) 6).