Scholarlink

Objective <p>This meta-analysis evaluates the efficacy and safety of middle meningeal artery embolization (MMAE) combined with surgery versus surgery alone in chronic subdural hematoma (CSDH).</p> Methods <p>We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) comparing MMAE combined with surgery to surgery alone. And outcomes were pooled using a random-effects model. Primary efficacy outcome was treatment failure (recurrence or reoperation). Trial sequential analysis (TSA) employed to assess the robustness of the evidence for treatment failure. Primary safety outcomes included serious adverse events. Secondary efficacy outcomes included changes in hematoma volume, hematoma thickness, and functional independence (modified Rankin Scale [mRS] 0–2). Secondary safety outcome was all-cause mortality.</p> Results <p>A total of six RCTs, involving 1,222 patients, were included in the analysis. MMAE combined with surgery significantly reduced treatment failure risk (RR 0.56, 95% CI 0.35–0.89, P = 0.02) compared to surgery alone. In the TSA, the cumulative z-line crossed the boundary for effect. No significant differences were observed in serious adverse events (RR 1.10, 95% CI 0.84–1.44), changes in hematoma volume (MD -7.19; 95% CI, -25.25–10.86; P = 0.43), change in hematoma thickness (MD 0.08; 95% CI, -1.00–1.15; P = 0.89) or mortality (RR 1.52, 95% CI 0.81–2.85; P=&#xa0;0.19).</p> Conclusions <p>MMAE, as an adjunct to surgery, reduces the risk of treatment failure in CSDH without compromising safety outcomes, but further trials are needed for validation.&#xa0;</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Surgical evacuation without versus with middle meningeal artery embolization in chronic subdural hematoma: A meta-analysis of randomized controlled trials

  • 期刊论文

  • 发表日期：

    2025年6月16日

查看全文
  • Jun Liu,
  • Can Tang,
  • Lanjun Xie,
  • Weidong Liang,
  • Yongzhi Wang,
  • Yaqin Qin

摘要

Objective

This meta-analysis evaluates the efficacy and safety of middle meningeal artery embolization (MMAE) combined with surgery versus surgery alone in chronic subdural hematoma (CSDH).

Methods

We systematically searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) comparing MMAE combined with surgery to surgery alone. And outcomes were pooled using a random-effects model. Primary efficacy outcome was treatment failure (recurrence or reoperation). Trial sequential analysis (TSA) employed to assess the robustness of the evidence for treatment failure. Primary safety outcomes included serious adverse events. Secondary efficacy outcomes included changes in hematoma volume, hematoma thickness, and functional independence (modified Rankin Scale [mRS] 0–2). Secondary safety outcome was all-cause mortality.

Results

A total of six RCTs, involving 1,222 patients, were included in the analysis. MMAE combined with surgery significantly reduced treatment failure risk (RR 0.56, 95% CI 0.35–0.89, P = 0.02) compared to surgery alone. In the TSA, the cumulative z-line crossed the boundary for effect. No significant differences were observed in serious adverse events (RR 1.10, 95% CI 0.84–1.44), changes in hematoma volume (MD -7.19; 95% CI, -25.25–10.86; P = 0.43), change in hematoma thickness (MD 0.08; 95% CI, -1.00–1.15; P = 0.89) or mortality (RR 1.52, 95% CI 0.81–2.85; P= 0.19).

Conclusions

MMAE, as an adjunct to surgery, reduces the risk of treatment failure in CSDH without compromising safety outcomes, but further trials are needed for validation.