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 : 2025-02-01 Epub Date: 2025-01-02 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

{"title":"Complications of Middle Meningeal Artery Embolization: A Systematic Review and Meta-Analysis.","authors":"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","doi":"10.1016/j.wneu.2024.11.124","DOIUrl":null,"url":null,"abstract":"Background: Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma. 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 used to calculate the pooled incidence of complications stratified based on whether studies excluded patients with comorbidities. Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed.Results: A final 34 studies containing 921 patients undergoing MMAE were included that reported 35 complications. Neurological complications were reported in 7 studies with an overall pooled incidence of 3.8% (95% confidence interval [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, 7 studies reported cardiovascular complications with an overall pooled incidence of 3.6% (95% CI: 2.4%-5.4%), 4 studies reported infectious complications with an overall pooled incidence of 2.9% (95% CI: 1.9%-4.5%), and 3 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 was 3.2% (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% (95% CI: 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.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123541"},"PeriodicalIF":1.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.11.124","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/2 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma. 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 used to calculate the pooled incidence of complications stratified based on whether studies excluded patients with comorbidities. Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed.

Results: A final 34 studies containing 921 patients undergoing MMAE were included that reported 35 complications. Neurological complications were reported in 7 studies with an overall pooled incidence of 3.8% (95% confidence interval [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, 7 studies reported cardiovascular complications with an overall pooled incidence of 3.6% (95% CI: 2.4%-5.4%), 4 studies reported infectious complications with an overall pooled incidence of 2.9% (95% CI: 1.9%-4.5%), and 3 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 was 3.2% (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% (95% CI: 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.

查看原文本刊更多论文

脑膜中动脉栓塞的并发症-系统回顾和荟萃分析。

背景：脑膜中动脉栓塞（MMAE）是慢性硬膜下血肿（cSDH）的一种成熟的治疗选择。本系统综述和荟萃分析的目的是对MMAE术后并发症的总发生率进行估计。方法：检索PubMed， Embase和Cochrane到2023年1月报告MMAE并发症的研究。采用随机效应模型，根据研究是否排除有合并症的患者，分层计算合并并发症的发生率。遵循PRISMA检查表。结果：最终纳入34项研究，921例患者接受MMAE，报告了35例并发症。7项研究报告了神经系统并发症，总合并发病率为3.8%（95%CI: 2.6%-5.5%）。在这些研究中，未排除、未提及或排除合并症患者的研究中，合并发生率分别为4.9% （95%CI: 2.9%-8.0%）、3.0% （95%CI: 1.7%-5.3%）和2.1% （95%CI: 0.4%-9.7%）。同样，7项研究报告了心血管并发症，总合并发生率为3.6%(95%CI: 2.4%-5.4%)， 4项研究报告了感染性并发症，总合并发生率为2.9%(95%CI: 1.9% - 4.5%)， 3项研究报告了其他并发症，总合并发生率为3.1%（95%CI: 2.0%-4.8%）。进一步的亚组分析显示，在未排除合并合并症患者的研究中，心血管并发症的总发生率为3.2%(95%CI: 1.7%-6.1%)，在未明确排除合并合并症患者的研究中，心血管并发症的总发生率为4.1%(95%CI: 2.3%-7.1%)，在排除合并合并症患者的研究中，心血管并发症的总发生率为1.8%（95%CI: 0.2%-11.5%）。同样，这些组的感染并发症发生率分别为3.3%（95%CI: 1.7%-6.2%）、2.7%（95%CI: 1.5%-5.0%）和1.8%（95%CI: 0.2%-11.5%）。分别。其他并发症的发生率分别为4.0%（95%CI: 2.2% ~ 7.2%）、2.3%（95%CI: 1.1% ~ 4.6%）和3.1%（95%CI: 0.9% ~ 10.1%）。结论：已发表的文献表明MMAE是一种普遍耐受良好的手术，并发症风险低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

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