• Mahnoor Shafi, Shrikar R Badikol, Jakob V E Gerstl, Noah L A Nawabi, Madhav Sukumaran, Ari D Kappel, Abdullah H Feroze, Timothy R Smith, Rania A Mekary, and Mohammad Ali Aziz-Sultan.
• Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: mahnoorshafi21@gmail.com.
• World Neurosurg. 2024 Dec 9.

BackgroundMiddle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma (cSDH). The aim of this systematic review and meta-analysis was to establish estimates of the pooled incidence for complications following MMAE.MethodsPubMed, Embase and Cochrane were searched for studies reporting complications following MMAE through January 2023. A random effects model was utilized to calculate the pooled incidence of complications stratified based on whether studies excluded patients with comorbidities. PRISMA checklist was followed.ResultsA final 34 studies containing 921 patients undergoing MMAE were included that reported 35 complications. Neurological complications were reported in seven studies with an overall pooled incidence of 3.8%(95%CI: 2.6%-5.5%). Across these studies, there was a pooled incidence of 4.9% (95%CI: 2.9%-8.0%), 3.0% (95%CI: 1.7%-5.3%), and 2.1% (95%CI: 0.4%-9.7%) in studies that did not exclude, did not mention, or excluded patients with comorbidities respectively. Similarly, seven studies reported cardiovascular complications with an overall pooled incidence of 3.6%(95%CI: 2.4%-5.4%), four studies reported infectious complications with an overall pooled incidence of 2.9%(95%CI: 1.9%4.5%), and three studies reported for miscellaneous complications with an overall pooled incidence of 3.1%(95%CI: 2.0%-4.8%). Further subgroup analysis revealed the pooled incidence of cardiovascular complications was3.2%(95%CI: 1.7%-6.1%) in studies that did not exclude patients with comorbidities, 4.1%(95%CI: 2.3%-7.1% in studies that did not specify the exclusion of such patients, and 1.8%(95CI: 0.2%-11.5% in studies that excluded these patients. Similarly, the incidence of infectious complications was 3.3%(95%CI: 1.7%-6.2%), 2.7%(95%CI: 1.5%-5.0%), and 1.8%(95%CI: 0.2%-11.5%) across these groups. respectively. Miscellaneous complications were reported at 4.0%(95%CI: 2.2%-7.2%), 2.3%(95%CI: 1.1%-4.6%), and 3.1%(95%CI: 0.9%-10.1%), respectively.ConclusionsThe published literature suggests that MMAE is a generally well-tolerated procedure with a low risk of significant complications.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

3 keywords...

hide…