{"title":"脑膜中动脉栓塞与钻孔引流治疗慢性硬膜下血肿的疗效和安全性的倾向评分匹配分析。","authors":"Junhui Li, Zhengwen Chen, Junjie Shao, Qi Jia, Zhixiang Fan, Qingfeng Huang, Xiaojian Lu","doi":"10.1007/s00234-025-03740-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of middle meningeal artery embolization (MMAE) and burr hole drainage in the treatment of chronic subdural hematoma (CSDH).</p><p><strong>Methods: </strong>Patients diagnosed with CSDH who underwent MMAE or surgical treatment were retrospectively recruited to this single-center study. Propensity score matching (PSM) analysis was carried out to compare the efficacy and safety of MMAE and burr hole drainage. Efficacy outcomes included hematoma clearance, cure, recurrence, and re-intervention rates within a 90-day postoperative follow-up period. Safety outcomes included the modified Rankin Scale (mRS) of 0-2 at the 90-day postoperative follow-up, procedure-related complications during hospitalization, and hospital stay length.</p><p><strong>Results: </strong>Among the 183 CSDH patients, 34.4% (63 patients) received MMAE and 65.6% (120 patients) underwent burr hole drainage surgery. The MMAE group showed a higher hematoma clearance rate (90.62±8.98% vs. 81.12±18.62%, P=0.005), higher cure rate (63.4% vs. 41.5%, P=0.047), and lower recurrence rate (2.4% vs. 14.6%, P=0.048) after PSM compared to the burr hole group. The re-intervention rates in the MMAE and burr hole groups showed no significant differences (2.4% vs. 7.3%, P=0.305). Safety outcomes favored the MMAE group, with a lower 90-day mRS score (0.34±0.53 vs. 0.73±0.55, P=0.02) and shorter hospital stay (6.41±2.53 days vs. 9.29±3.71 days, P<0.001). Surgery-related adverse events occurred in 4.9% of the MMAE group and 9.7% of the burr hole group patients (P=0.392).</p><p><strong>Conclusions: </strong>MMAE was a safe and efficacious alternative procedure for CSDH treatment that showed a reduced recurrence rate.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A propensity score matching analysis of the efficacy and safety of middle meningeal artery embolization versus burr hole drainage in the treatment of chronic subdural hematomas.\",\"authors\":\"Junhui Li, Zhengwen Chen, Junjie Shao, Qi Jia, Zhixiang Fan, Qingfeng Huang, Xiaojian Lu\",\"doi\":\"10.1007/s00234-025-03740-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare the efficacy and safety of middle meningeal artery embolization (MMAE) and burr hole drainage in the treatment of chronic subdural hematoma (CSDH).</p><p><strong>Methods: </strong>Patients diagnosed with CSDH who underwent MMAE or surgical treatment were retrospectively recruited to this single-center study. Propensity score matching (PSM) analysis was carried out to compare the efficacy and safety of MMAE and burr hole drainage. Efficacy outcomes included hematoma clearance, cure, recurrence, and re-intervention rates within a 90-day postoperative follow-up period. Safety outcomes included the modified Rankin Scale (mRS) of 0-2 at the 90-day postoperative follow-up, procedure-related complications during hospitalization, and hospital stay length.</p><p><strong>Results: </strong>Among the 183 CSDH patients, 34.4% (63 patients) received MMAE and 65.6% (120 patients) underwent burr hole drainage surgery. The MMAE group showed a higher hematoma clearance rate (90.62±8.98% vs. 81.12±18.62%, P=0.005), higher cure rate (63.4% vs. 41.5%, P=0.047), and lower recurrence rate (2.4% vs. 14.6%, P=0.048) after PSM compared to the burr hole group. The re-intervention rates in the MMAE and burr hole groups showed no significant differences (2.4% vs. 7.3%, P=0.305). Safety outcomes favored the MMAE group, with a lower 90-day mRS score (0.34±0.53 vs. 0.73±0.55, P=0.02) and shorter hospital stay (6.41±2.53 days vs. 9.29±3.71 days, P<0.001). Surgery-related adverse events occurred in 4.9% of the MMAE group and 9.7% of the burr hole group patients (P=0.392).</p><p><strong>Conclusions: </strong>MMAE was a safe and efficacious alternative procedure for CSDH treatment that showed a reduced recurrence rate.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-025-03740-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03740-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：比较脑膜中动脉栓塞术（MMAE）与钻孔引流术治疗慢性硬膜下血肿（CSDH）的疗效和安全性。方法：回顾性招募经MMAE或手术治疗的CSDH患者进行单中心研究。采用倾向评分匹配（PSM）分析比较MMAE和钻孔引流的疗效和安全性。疗效指标包括血肿清除、治愈、复发率和术后90天随访期内的再干预率。安全性指标包括术后90天随访时修改的Rankin量表（mRS） 0-2，住院期间手术相关并发症和住院时间。结果：183例CSDH患者中，34.4%（63例）采用MMAE， 65.6%（120例）采用钻孔引流术。与钻孔组相比，MMAE组术后血肿清除率（90.62±8.98%比81.12±18.62%，P=0.005）、治愈率（63.4%比41.5%，P=0.047）、复发率（2.4%比14.6%，P=0.048）均高于钻孔组。MMAE组和钻孔组的再干预率差异无统计学意义（2.4% vs. 7.3%， P=0.305）。安全性方面，MMAE组的90天mRS评分较低（0.34±0.53比0.73±0.55，P=0.02），住院时间较短（6.41±2.53天比9.29±3.71天）。结论：MMAE是一种安全有效的替代CSDH治疗方法，复发率降低。
A propensity score matching analysis of the efficacy and safety of middle meningeal artery embolization versus burr hole drainage in the treatment of chronic subdural hematomas.
Objective: To compare the efficacy and safety of middle meningeal artery embolization (MMAE) and burr hole drainage in the treatment of chronic subdural hematoma (CSDH).
Methods: Patients diagnosed with CSDH who underwent MMAE or surgical treatment were retrospectively recruited to this single-center study. Propensity score matching (PSM) analysis was carried out to compare the efficacy and safety of MMAE and burr hole drainage. Efficacy outcomes included hematoma clearance, cure, recurrence, and re-intervention rates within a 90-day postoperative follow-up period. Safety outcomes included the modified Rankin Scale (mRS) of 0-2 at the 90-day postoperative follow-up, procedure-related complications during hospitalization, and hospital stay length.
Results: Among the 183 CSDH patients, 34.4% (63 patients) received MMAE and 65.6% (120 patients) underwent burr hole drainage surgery. The MMAE group showed a higher hematoma clearance rate (90.62±8.98% vs. 81.12±18.62%, P=0.005), higher cure rate (63.4% vs. 41.5%, P=0.047), and lower recurrence rate (2.4% vs. 14.6%, P=0.048) after PSM compared to the burr hole group. The re-intervention rates in the MMAE and burr hole groups showed no significant differences (2.4% vs. 7.3%, P=0.305). Safety outcomes favored the MMAE group, with a lower 90-day mRS score (0.34±0.53 vs. 0.73±0.55, P=0.02) and shorter hospital stay (6.41±2.53 days vs. 9.29±3.71 days, P<0.001). Surgery-related adverse events occurred in 4.9% of the MMAE group and 9.7% of the burr hole group patients (P=0.392).
Conclusions: MMAE was a safe and efficacious alternative procedure for CSDH treatment that showed a reduced recurrence rate.
期刊介绍：
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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