Abstract Details

Title Adjunct Middle Meningeal Artery Embolization Versus Surgery for Chronic Subdural Hematoma: A Systematic Review and Meta-analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 4-012

Objective This meta-analysis aimed to compare clinical outcomes between adjunctive MMAE combined with surgery and surgery alone in patients with cSDH

Background Chronic subdural haematoma (cSDH) is a prevalent neurosurgical condition with notable recurrence rates following surgical evacuation. Middle meningeal artery embolisation (MMAE) has emerged as a promising adjunct to reduce recurrence, yet its added benefit when combined with surgery remains inconsistent across studies.

Design/Methods A systematic search of six databases was conducted from inception to March 2025. The primary outcomes were treatment failure, reoperation rate, and length of hospital stay. Outcomes were reported as odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CI). A random-effects model was used for all analyses.

Results Twenty studies published between 2017 and 2025, comprising 60,940 patients, met the inclusion criteria. MMAE significantly reduced the treatment failure rate (10.77% in the MMAE plus surgery group vs. 16.69% in the surgery-alone group; p = 0.04), though the certainty of evidence was low. No significant difference was observed in reoperation rates (6.96% vs. 3.26%; p = 0.19), with moderate certainty of evidence. Ten studies reported on hospital stay duration, showing no significant difference between groups (SMD = 0.19 days; 95% CI: –0.07 to 0.45; p = 0.15), with very low certainty of evidence.

Conclusions Our systematic review and meta-analysis suggest that adjunct MMAE to surgery is more safer and potentially more effective strategy than surgery alone. Ongoing randomised clinical trials may be needed in the future with a longer follow-up duration.

Authors/Disclosures
Omar F. Abbas PRESENTER	Omar F. Abbas has nothing to disclose.
Roaa M. Haddad, MD	Dr. Haddad has nothing to disclose.
Youmna Zain, MBBS	Dr. Eid Zain El-din has nothing to disclose.
Hala AbouShawareb, MD	Dr. AbouShawareb has nothing to disclose.
Abdullah H. Almarfadi II (Faculte de medecine)	Mr. Almarfadi has nothing to disclose.
Afaf Bachira Gouhiri, MD	Dr. Gouhiri has nothing to disclose.
Mohab A. Saad	Dr. Saad has nothing to disclose.
Yousif A. Hanafi, MBBS	Dr. Hanafi has nothing to disclose.
Mohamed A. Aldemerdash, MBBS	Dr. A. Aldemerdash has nothing to disclose.
Mohamed M. Mohsen Helal	Dr. Mohsen Helal has nothing to disclose.
Dalia A. Abouda	Dr. Abouda has nothing to disclose.

��ɫ��

��ɫ��