Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization
Objective: To study the efficacy of middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematoma (SDH) and characterize its post-embolization volumetric resolution. Methods: Ten patients diagnosed with 13 cSDH underwent MMA embolization. SDH volumes were measured from ti...
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| Format: | Article |
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MDPI AG
2021-02-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/2/257 |
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| author | Ambooj Tiwari Adam A. Dmytriw Ryan Bo Nathan Farkas Phillip Ye David S. Gordon Karthikeyan M. Arcot David Turkel-Parrella Jeffrey Farkas |
| author_facet | Ambooj Tiwari Adam A. Dmytriw Ryan Bo Nathan Farkas Phillip Ye David S. Gordon Karthikeyan M. Arcot David Turkel-Parrella Jeffrey Farkas |
| author_sort | Ambooj Tiwari |
| collection | DOAJ |
| description | Objective: To study the efficacy of middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematoma (SDH) and characterize its post-embolization volumetric resolution. Methods: Ten patients diagnosed with 13 cSDH underwent MMA embolization. SDH volumes were measured from time of initial discovery on imaging to pre-operative, post-operative, short-term and long-term follow-up. Time between procedure to obliteration was also measured. Volumetric analysis was done using the coniglobus formula, and recurrence rate as well as resolution timeline was defined using best-fit models. Results: Out of 10 patients, five were recurrent lesions, three were bilateral and seven unilateral cSDH. Average and median pre-operative volumes were 105.3 cc and 97.4 cc, respectively. Embolization on average was performed 21 days after discovery. Sixty percent of patients had concurrent antiplatelets or anticoagulation use. Forty percent underwent embolization treatment as the primary therapy. Recurrence was not seen in any patients treated with embolization. There were no peri- or post-operative complications. Five patients experienced complete or near-complete obliteration, while those with partial resolution showed a composite average of 75% volumetric reduction in 45 days. Post-embolization, the volumetric resolution followed an exponential decay curve over time and was independent of initial volume. Conclusion: MMA embolization contributed to a marked reduction in SDH volume post-operatively and can be used as a curative therapy for primary or recurrent chronic SDH. |
| first_indexed | 2024-03-09T05:17:08Z |
| format | Article |
| id | doaj.art-59ee9d7c1e4042398d6fd011bf32c9e9 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T05:17:08Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-59ee9d7c1e4042398d6fd011bf32c9e92023-12-03T12:44:03ZengMDPI AGDiagnostics2075-44182021-02-0111225710.3390/diagnostics11020257Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery EmbolizationAmbooj Tiwari0Adam A. Dmytriw1Ryan Bo2Nathan Farkas3Phillip Ye4David S. Gordon5Karthikeyan M. Arcot6David Turkel-Parrella7Jeffrey Farkas8Interventional Neuro Associates, 43 Westminster Avenue, Bergenfield, NJ 06721, USANeuroradiology & Neurointervention Service, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USAInterventional Neuro Associates, 43 Westminster Avenue, Bergenfield, NJ 06721, USAInterventional Neuro Associates, 43 Westminster Avenue, Bergenfield, NJ 06721, USAInterventional Neuro Associates, 43 Westminster Avenue, Bergenfield, NJ 06721, USADepartments of Neurology, Radiology & Neurosurgery, NYU School of Medicine & New York University Langone Health, Brooklyn, NY 11220, USAInterventional Neuro Associates, 43 Westminster Avenue, Bergenfield, NJ 06721, USAInterventional Neuro Associates, 43 Westminster Avenue, Bergenfield, NJ 06721, USAInterventional Neuro Associates, 43 Westminster Avenue, Bergenfield, NJ 06721, USAObjective: To study the efficacy of middle meningeal artery (MMA) embolization for the treatment of chronic subdural hematoma (SDH) and characterize its post-embolization volumetric resolution. Methods: Ten patients diagnosed with 13 cSDH underwent MMA embolization. SDH volumes were measured from time of initial discovery on imaging to pre-operative, post-operative, short-term and long-term follow-up. Time between procedure to obliteration was also measured. Volumetric analysis was done using the coniglobus formula, and recurrence rate as well as resolution timeline was defined using best-fit models. Results: Out of 10 patients, five were recurrent lesions, three were bilateral and seven unilateral cSDH. Average and median pre-operative volumes were 105.3 cc and 97.4 cc, respectively. Embolization on average was performed 21 days after discovery. Sixty percent of patients had concurrent antiplatelets or anticoagulation use. Forty percent underwent embolization treatment as the primary therapy. Recurrence was not seen in any patients treated with embolization. There were no peri- or post-operative complications. Five patients experienced complete or near-complete obliteration, while those with partial resolution showed a composite average of 75% volumetric reduction in 45 days. Post-embolization, the volumetric resolution followed an exponential decay curve over time and was independent of initial volume. Conclusion: MMA embolization contributed to a marked reduction in SDH volume post-operatively and can be used as a curative therapy for primary or recurrent chronic SDH.https://www.mdpi.com/2075-4418/11/2/257volumetric imagingsubdural hematomaembolizationcerebral angiographyneuroradiology |
| spellingShingle | Ambooj Tiwari Adam A. Dmytriw Ryan Bo Nathan Farkas Phillip Ye David S. Gordon Karthikeyan M. Arcot David Turkel-Parrella Jeffrey Farkas Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization Diagnostics volumetric imaging subdural hematoma embolization cerebral angiography neuroradiology |
| title | Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization |
| title_full | Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization |
| title_fullStr | Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization |
| title_full_unstemmed | Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization |
| title_short | Recurrence and Coniglobus Volumetric Resolution of Subacute and Chronic Subdural Hematoma Post-Middle Meningeal Artery Embolization |
| title_sort | recurrence and coniglobus volumetric resolution of subacute and chronic subdural hematoma post middle meningeal artery embolization |
| topic | volumetric imaging subdural hematoma embolization cerebral angiography neuroradiology |
| url | https://www.mdpi.com/2075-4418/11/2/257 |
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