注射玛瑙的体积是否影响硬膜下血肿脑膜中动脉栓塞后的预后？

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-09-23 DOI:10.1016/j.jocn.2025.111651

Joanna M. Roy , Basel Musmar , Spyridon Karadimas , Saman Sizdahkhani , Arbaz Momin , Mary-Katharine Pontarelli , Ajay Garg , Eleni Papadopoulos , Vinay Pedapati , Arashleen Pannu , Stavropoula I. Tjoumakaris , M. Reid Gooch , Robert H. Rosenwasser , Pascal Jabbour

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引用次数: 0

摘要

背景与目的最近的文献强调了液体栓塞剂如玛瑙在硬膜下血肿（SDH）的脑膜中动脉（MMA）栓塞中的疗效。我们的研究旨在评估注射Onyx的体积是否会影响接受MMA栓塞治疗SDH的患者的预后。方法回顾性研究了2019年3月至2024年12月在同一家机构使用Onyx进行MMA栓塞治疗SDH的患者。使用颗粒栓塞的患者被排除在外。根据Onyx注射中位体积的第75个百分位数将患者分为≥0.7 ml和0.7 ml两组。主要结局是栓塞失败，定义为血肿厚度增加或需要手术清除。次要终点是延长住院时间（eLOS），定义为LOS高于中位数的第75个百分位。结果共纳入123例MMA栓塞术。该队列的平均年龄为71.7±13.5岁，26% （n = 32）为女性。70.7%的患者（n = 87）接受了低体积（<0.7 ml）的Onyx。Onyx的体积与栓塞失败或eLOS无关。女性（OR: 0.24, 95% CI: 0.06-0.89, P = 0.034）与eLOS发生率较低相关，而基线功能依赖与eLOS发生率较高相关（OR: 6.34, 95% CI: 2.24-17.97, P < 0.001）。结论注射Onyx量不能预测MMA栓塞治疗SDH后栓塞失败或eLOS。未来的研究可以通过前瞻性的多中心研究来帮助验证我们的初步发现。

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Does the volume of Onyx injected influence outcomes after middle meningeal artery embolization for subdural hematoma?

Background and objectives

Recent literature has highlighted the efficacy of liquid embolic agents like Onyx for middle meningeal artery (MMA) embolization of subdural hematoma (SDH). Our study aims to assess whether the volume of Onyx injected affects outcomes in patients undergoing MMA embolization for SDH.

Methods

This was a retrospective study of patients who underwent MMA embolization using Onyx for SDH at a single institution between March 2019- December 2024. Patients who underwent embolization using particles were excluded. Patients were dichotomized into two groups (≥0.7 ml or <0.7 ml) based on the 75th percentile of median volume of Onyx injected. The primary outcome of interest was embolization failure, defined as increase in hematoma thickness or need for surgical evacuation. The secondary outcome of interest was extended length of stay (eLOS), defined as LOS above the 75th percentile of the median.

Results

A total of 123 MMA embolization procedures were included. The mean age of the cohort was 71.7 ± 13.5 years, and 26 % (n = 32) were female. 70.7 % of patients (n = 87) received a lower volume (<0.7 ml) of Onyx. Volume of Onyx was not associated with embolization failure or eLOS. Female gender (OR: 0.24, 95 % CI: 0.06–0.89, P = 0.034) was associated with lower odds of eLOS, while baseline functional dependence was associated with higher odds of eLOS (OR: 6.34, 95 % CI: 2.24–17.97, P < 0.001).

Conclusion

The volume of Onyx injected does not predict embolization failure or eLOS after MMA embolization for SDH. Future research could help validate our preliminary findings through prospective multicenter studies.

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.