The middle meningeal artery Patency After Coil Embolization (PACE) score: A novel descriptor of angiographic occlusion.

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Interventional Neuroradiology Pub Date : 2024-12-23 DOI:10.1177/15910199241308324

Nicholas S Hernandez, Ryan W Sindewald, Michael G Brandel, Arvin R Wali, Nikhil K Murthy, Jeffrey A Steinberg, Jeffrey S Pannell, Alexander A Khalessi, David R Santiago-Dieppa

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引用次数: 0

Abstract

Introduction: A scoring system to characterize the efficacy of middle meningeal artery (MMA) embolization is lacking and would help predict the likelihood of subdural hematoma resolution.

Methods: We developed a simple angiographic classification system ranging from 0 to 3 for quantifying MMA Patency After Coil Embolization (PACE) based residual flow distal to the embolization. MMA embolizations using coils at our institution were used to validate the PACE score system using procedural angiograms. Follow-up CT scans following embolization were reviewed for acute blood products, and to characterize long-term resolution.

Results: 60 patients were included in the study, with a total of 80 subdural hematomas with follow-up imaging that were available for analysis. 37 patients had a PACE score of 0, 18 had a PACE score of 1, 4 had a PACE score of 2, and 1 had a PACE score of 3. The presence of acute blood products was significantly lower in PACE 0 compared to PACE 1, 2, or 3. The cross-sectional area of the chronic subdural collections was statistically lower on follow-up CT scans after coil embolization.

Conclusions: Coil embolization of the MMA may reduce the incidence of acute blood products after embolization and decrease the cross-sectional area of chronic subdural hematoma on long-term follow-up. Lower PACE scores may correlate with lower rates of acute blood products after the procedure and increased resolution of chronic subdural hematoma on follow-up. A larger cohort is required to characterize the superiority between the PACE scores.

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螺旋栓塞后脑膜中动脉通畅度（PACE）评分：一种新的血管造影闭塞描述符。

目前缺乏一种评价脑膜中动脉（MMA）栓塞疗效的评分系统，该评分系统将有助于预测硬膜下血肿消退的可能性。方法：我们开发了一个简单的血管造影分类系统，范围从0到3，用于量化MMA通畅后线圈栓塞（PACE）基于栓塞远端残余血流。在我们的机构使用线圈MMA栓塞来验证PACE评分系统的程序性血管造影。随访CT扫描栓塞后的急性血液制品进行审查，并表征长期解决。结果：60例患者纳入研究，共有80例硬膜下血肿，随访影像可用于分析。37例患者的PACE评分为0,18例为1,4例为2,1例为3。与PACE 1、2和3相比，PACE 0中急性血液制品的存在显著降低。在线圈栓塞后的随访CT扫描中，慢性硬膜下积液的横截面积有统计学意义上的降低。结论：经长期随访，线圈栓塞MMA可降低栓塞后急性血产物的发生率，减少慢性硬膜下血肿的横截面积。较低的PACE评分可能与手术后较低的急性血制品率和随访中慢性硬膜下血肿的消退有关。需要一个更大的队列来表征PACE分数之间的优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

3.60

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...