Complications of Middle Meningeal Artery Embolization - A Systematic Review and Meta-Analysis.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2024-12-09 DOI:10.1016/j.wneu.2024.11.124

Mahnoor Shafi, Shrikar R Badikol, Jakob V E Gerstl, Noah L A Nawabi, Madhav Sukumaran, Ari D Kappel, Abdullah H Feroze, Timothy R Smith, Rania A Mekary, Mohammad Ali Aziz-Sultan

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引用次数: 0

Abstract

Background: Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma (cSDH). The aim of this systematic review and meta-analysis was to establish estimates of the pooled incidence for complications following MMAE.

Methods: PubMed, Embase and Cochrane were searched for studies reporting complications following MMAE through January 2023. A random effects model was utilized to calculate the pooled incidence of complications stratified based on whether studies excluded patients with comorbidities. PRISMA checklist was followed.

Results: A final 34 studies containing 921 patients undergoing MMAE were included that reported 35 complications. Neurological complications were reported in seven studies with an overall pooled incidence of 3.8%(95%CI: 2.6%-5.5%). Across these studies, there was a pooled incidence of 4.9% (95%CI: 2.9%-8.0%), 3.0% (95%CI: 1.7%-5.3%), and 2.1% (95%CI: 0.4%-9.7%) in studies that did not exclude, did not mention, or excluded patients with comorbidities respectively. Similarly, seven studies reported cardiovascular complications with an overall pooled incidence of 3.6%(95%CI: 2.4%-5.4%), four studies reported infectious complications with an overall pooled incidence of 2.9%(95%CI: 1.9%4.5%), and three studies reported for miscellaneous complications with an overall pooled incidence of 3.1%(95%CI: 2.0%-4.8%). Further subgroup analysis revealed the pooled incidence of cardiovascular complications was3.2%(95%CI: 1.7%-6.1%) in studies that did not exclude patients with comorbidities, 4.1%(95%CI: 2.3%-7.1% in studies that did not specify the exclusion of such patients, and 1.8%(95CI: 0.2%-11.5% in studies that excluded these patients. Similarly, the incidence of infectious complications was 3.3%(95%CI: 1.7%-6.2%), 2.7%(95%CI: 1.5%-5.0%), and 1.8%(95%CI: 0.2%-11.5%) across these groups. respectively. Miscellaneous complications were reported at 4.0%(95%CI: 2.2%-7.2%), 2.3%(95%CI: 1.1%-4.6%), and 3.1%(95%CI: 0.9%-10.1%), respectively.

Conclusions: The published literature suggests that MMAE is a generally well-tolerated procedure with a low risk of significant complications.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS