治疗前血肿大小和单侧与双侧MMA栓塞对慢性硬膜下血肿治疗减容的影响:一项回顾性队列研究。

IF 1.5 4区 医学 Q4 CLINICAL NEUROLOGY
Andrew Falzon, Ahmed Abdelghafar, Eef Hendriks, Hugo Andrade Barazarte, Alex Kostynskyy, Alexandre Boutet, Ze'ev Itsekzon-Hayosh, Pascal J Mosimann
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引用次数: 0

摘要

背景和目的尽管越来越多的文献支持脑膜中动脉栓塞(MMAE)治疗慢性硬膜下血肿(cSDH),但实际数据仍然很少。本研究旨在评估MMAE的放射学和临床结果,基于放射学特征。材料和方法纳入52例cSDH患者,在单一三级中心接受MMAE作为cSDH后排空治疗。与mmae前CT头部成像相比,通过常规随访的cSDH厚度/体积差来评估放射学结果。该队列根据cSDH偏侧性(双侧和单侧cSDH)和mmae前血肿厚度(>15 mm和≤15 mm)分为两组进行分析。为了消除手术对血肿进展影响的偏倚,在MMAE后进行疏散的患者未被纳入分析。结果双侧cSDH 30例,单侧cSDH 22例。29例患者mmae前血肿厚度≤15mm, 23例患者mmae前血肿厚度≤15mm。与基线相比,在所有随访时间间隔内,平均cSDH体积都较低,在3-6个月的随访时间间隔内减少了10倍。与两组(双侧和单侧MMAE)(治疗前血肿厚度>15 mm和≤15 mm)相比,在所有三个随访间隔内cSDH平均厚度均显著降低。厚度为> - 15mm的较大血肿比≤15mm的血肿(1-3个月- 63mm3, 40.6-85.69, p15mm(与≤15mm相比)和单侧cSDH和MMAE(与双侧cSDH和MMAE相比)的平均cSDH体积间隔随访明显减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of pre-treatment hematoma size and unilateral vs bilateral MMA embolization on volume reduction in the treatment of chronic subdural hematomas: A retrospective cohort study.

Background and purposeDespite a rapidly growing body of literature supporting the treatment of chronic subdural hematoma (cSDH) with middle meningeal artery embolization (MMAE), real-life data is still scarce. This study aimed to evaluate MMAE radiological and clinical outcomes, based on radiological characteristics.Materials and MethodsFifty-two cSDH patients, treated by MMAE as a post-CSDH evacuation therapy in a single tertiary center, were included. Radiological outcome was evaluated with cSDH thickness/volume difference at routine follow-up compared to pre-MMAE CT head imaging. The cohort was divided into groups pertaining to cSDH laterality (bilateral and unilateral cSDH) and pre-MMAE hematoma thickness (>15 mm and ≤15 mm) for analysis. Patients who underwent evacuation after MMAE were not included in the analysis to eliminate bias of surgical effect on hematoma progression.ResultsThirty patients had bilateral, and 22 patients had unilateral cSDH treated with bilateral and unilateral MMAE respectively. Twenty-nine patients had >15 mm pre-MMAE hematoma thickness, and 23 had ≤15 mm pre-MMAE hematoma thickness. Mean cSDH volume was lower at all follow-up intervals when compared to baseline and was reduced by a factor of 10 at the 3-6-month interval. The mean cSDH thickness was significantly lower at all three follow-up intervals when comparing each group (bilateral and unilateral MMAE) (pre-treatment hematoma thickness >15 mm and ≤15 mm). Larger hematomas with a thickness of >15 mm had a significantly greater reduction in mean cSDH volume interval follow-up than hematomas measuring ≤15 mm (1-3 months-63 mm3, 40.6-85.69, P < .001). Unilateral cSDH and MMAE demonstrated greater cSDH volume reduction compared to bilateral cSDH and MMAE at 1-3 months (42, 15.2-68.8, .001) and 3-6 months (33.7, 5.2-72.7, .043). No procedure-related major complications or deaths or recurrences were observed.ConclusionsAdjunctive MMAE after surgical evacuation appears safe and effective. MMAE is particularly effective for larger pre-treatment hematomas >15 mm (compared to ≤15 mm) and for unilateral cSDH and MMAE (compared to bilateral cSDH and MMAE).

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来源期刊
Interventional Neuroradiology
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...
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