ASA: Embolization of MMA Cuts Risk for Subsequent Subdural Hematoma, Surgery

Complications related to the embolization procedure low, and neurological function comparable with, without embolization
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Medically Reviewed By:
Mark Arredondo, M.D.

WEDNESDAY, Feb. 14, 2024 (HealthDay News) -- For patients with symptomatic subacute or chronic subdural hematoma (SDH), embolization of the middle meningeal artery (MMA) as an adjunct to surgery reduces the risk for subsequent SDH and need for surgical drainage, according to a study presented at the annual American Stroke Association International Stroke Conference, held from Feb. 7 to 9 in Phoenix.

Jared Knopman, M.D., from Weill Cornell Medical College in New York City, and colleagues examined the safety and effectiveness of Onyx Liquid Embolic System embolization of the MMA as an adjunct to conventional treatment for patients with symptomatic subacute or chronic SDH in a trial that enrolled 400 individuals across 39 U.S. centers. Individuals who met the criteria for surgical evacuation were randomly assigned to receive surgery alone or surgery with adjunctive MMA embolization in a 1:1 ratio.

The researchers found that subsequent subdural hematoma within 90 days and need for surgical drainage occurred in 4.1 and 11.3 percent of those who underwent surgery plus embolization and surgery alone, respectively. Increasing disability and neurological dysfunction were comparable in both groups at 90 days after surgery, occurring in 11.9 and 9.8 percent of patients, respectively. Overall, 2 percent of patients who received embolization had serious adverse events attributed to embolization.

"The EMBOLISE trial showed that there was a nearly threefold reduction in re-operation for patients that were treated with surgery plus embolization," coauthor Jason Davies, M.D., Ph.D., from the State University of New York at Buffalo, said in a statement. "Fewer trips to the operating room mean less potential for pain, complications, recovery, and expense for the patient."

The study was funded by Medtronic Neurovascular Clinical Affairs. The Onyx Liquid Embolic System is manufactured by EV3, which is owned by Medtronic.

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