Material Matters: A Systematic Review and Meta-analysis of the Efficacy of Different Embolic Agents in Middle Meningeal Artery Embolization.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology Pub Date : 2025-09-26 DOI:10.1016/j.jvir.2025.09.030

Mitesh Gupta, Abhisek Saha, Abhishek Gupta, Madan Mohan Gupta, Manish Shaw, Praveen Singhal, Sanjiv Sharma

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引用次数: 0

Abstract

Purpose: To compare the efficacy and safety of different embolizing agents used in middle meningeal artery embolization for the treatment of chronic subdural hematoma.

Material and methods: A literature search of PubMed, Cochrane Library, Scopus, and Google Scholar (up to 2024) included studies reporting MMAE outcomes for cSDH. Study quality was evaluated using the Joanna Briggs Institute (JBI) and Risk of Bias 2 (RoB 2) tools. Pooled data were analyzed with random-effects models, with heterogeneity assessed via the I2 statistic. Statistical significance was set at p < 0.05.

Results: Of 997 articles screened, 33 studies (2013-2024) with 1,818 patients (mean age 74.2 ± 11 years, median follow-up 3 months) were included. The pooled recurrence rate after MMA embolization was 0.07 (95% CI: 0.05-0.10). By embolic agent, recurrence rates were: PVA 0.07, n-BCA 0.05, and EVOH 0.07. Periprocedural complication rates were low: PVA 0.02, n-BCA 0.01, EVOH 0.00; overall rate 0.01. Favourable clinical and radiologic outcomes were observed in 81% and 84% of cases, respectively.

Conclusion: MMA embolization is effective for cSDH, offering low recurrence and complication rates with favorable clinical and radiologic outcomes. All embolic agents demonstrated promising efficacy and safety profiles.

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材料问题：不同栓塞剂在脑膜中动脉栓塞疗效的系统回顾和荟萃分析。

目的：比较不同栓塞剂用于脑膜中动脉栓塞治疗慢性硬膜下血肿的疗效和安全性。材料和方法：检索PubMed、Cochrane Library、Scopus和谷歌Scholar（截至2024年）的文献，包括报道cSDH的MMAE结果的研究。使用乔安娜布里格斯研究所（JBI）和偏见风险2 （RoB 2）工具评估研究质量。用随机效应模型分析合并数据，通过I2统计量评估异质性。p < 0.05为差异有统计学意义。结果：在筛选的997篇文章中，33项研究（2013-2024年）纳入了1818例患者（平均年龄74.2±11岁，中位随访3个月）。MMA栓塞后合并复发率为0.07 （95% CI: 0.05 ~ 0.10）。栓塞剂的复发率分别为：PVA 0.07, n-BCA 0.05, EVOH 0.07。围手术期并发症发生率低：PVA 0.02, n-BCA 0.01, EVOH 0.00；总率0.01。在81%和84%的病例中分别观察到良好的临床和放射学结果。结论：MMA栓塞治疗cSDH疗效显著，复发率低，并发症发生率低，临床和影像学预后良好。所有栓塞剂均表现出良好的疗效和安全性。

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

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.