Journal of neurointerventional surgery · 2026
Single-session middle meningeal artery embolization and surgical evacuation for chronic subdural hematoma.
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Koo Andrew B, Stogniy Sasha, Elsamadicy Aladine A, Menon Sidharth S, Renedo Daniela, Reeves Benjamin, Sujijantarat Nanthiya, Hebert Ryan, de Havenon Adam, Sheth Kevin N, Matouk Charles
Аннотация
BACKGROUND: The aim of this study was to evaluate the preliminary experience of a combined middle meningeal artery embolization (MMAE) and burr hole evacuation approach for chronic subdural hematoma (cSDH) under a single anesthesia session.
METHODS: We performed a retrospective review of all patients who underwent MMAE and burr hole surgery during the same admission at a single major academic institution between 2019 and 2024. Patients were dichotomized by those with both procedures performed under a single anesthesia session (combined) or two separate sessions (separate). Baseline demographics, comorbidities, and complications were compared. The primary outcomes were in-hospital and 90-day complication and reoperation rates.
RESULTS: 103 patients were included in the study (median age 74 (67-81) years), with 33.9% in the combined cohort. Demographics, comorbidities, and radiographic characteristics were similar between the cohorts. While cumulative procedure times were similar (separate 85 (71-110) min vs combined 96 (82-127) min), total anesthesia time was significantly longer for patients with separate procedures (separate 225 (193-264) min vs combined 165 (145-183) min, P<0.001). There were no differences in the rates of access site complications, reoperation, stroke, or mortality between the cohorts. The combined cohort trended to have shorter length of stay (separate 6 (5-8) days vs combined 5 (4-7) days, P=0.058). There were no differences in complication or reoperation rates within 90 days.
CONCLUSION: The results of this study suggest that MMAE performed under a single anesthesia session with burr hole evacuation surgery is a safe and potentially resource-efficient approach for the management of cSDH.
METHODS: We performed a retrospective review of all patients who underwent MMAE and burr hole surgery during the same admission at a single major academic institution between 2019 and 2024. Patients were dichotomized by those with both procedures performed under a single anesthesia session (combined) or two separate sessions (separate). Baseline demographics, comorbidities, and complications were compared. The primary outcomes were in-hospital and 90-day complication and reoperation rates.
RESULTS: 103 patients were included in the study (median age 74 (67-81) years), with 33.9% in the combined cohort. Demographics, comorbidities, and radiographic characteristics were similar between the cohorts. While cumulative procedure times were similar (separate 85 (71-110) min vs combined 96 (82-127) min), total anesthesia time was significantly longer for patients with separate procedures (separate 225 (193-264) min vs combined 165 (145-183) min, P<0.001). There were no differences in the rates of access site complications, reoperation, stroke, or mortality between the cohorts. The combined cohort trended to have shorter length of stay (separate 6 (5-8) days vs combined 5 (4-7) days, P=0.058). There were no differences in complication or reoperation rates within 90 days.
CONCLUSION: The results of this study suggest that MMAE performed under a single anesthesia session with burr hole evacuation surgery is a safe and potentially resource-efficient approach for the management of cSDH.