Endovascular embolisation of the middle meningeal artery to treat chronic subdural haematomas: effectiveness, safety, and the current controversy. A systematic review

Neurologia (Engl Ed). 2023 Mar;38(2):124-130. doi: 10.1016/j.nrleng.2020.04.016. Epub 2021 Jan 10.

Abstract

Introduction: Chronic subdural haematoma (CSDH) represents a clinical challenge due to its high recurrence rate. Endovascular middle meningeal artery embolisation (eMMAE) has emerged as an alternative for those patients presenting health problems or multiple recurrences of CSDH. Despite several encouraging reports, the safety profile, indications, and limitations of the technique are not clearly established.

Development: This study aimed to evaluate the current evidence on eMMAE in patients with CSDH. We performed a systematic review of the literature, following the PRISMA guidelines. Our search yielded a total of 6 studies, in which a total of 164 patients with CSDH underwent eMMAE. The recurrence rate across all studies was 6.7%, and complications occurred in up to 6% of patients.

Conclusions: eMMAE is a feasible technique for treating CSDH, with a relatively low recurrence rate and an acceptable rate of complications. Further prospective and randomised studies are needed to formally establish a clear profile of the safety and effectiveness of the technique.

Keywords: Arteria meníngea; Embolisation; Embolización; Endovascular technique; Hematoma subdural; Meningeal artery; Neurocirugía; Neurosurgery; Recurrence; Recurrencia; Subdural haematoma; Terapéutica; Treatment; Técnica endovascular.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Embolization, Therapeutic*
  • Hematoma, Subdural, Chronic* / therapy
  • Humans
  • Meningeal Arteries