目的 评价脑膜中动脉(MMA)介入栓塞治疗慢性硬膜下血肿(CSDH)的安全性和有效性.方法 回顾性分析 2021 年 7 月至 2022 年 7 月皖南医学院弋矶山医院采用单纯MMA栓塞术治疗的 14 例(17 枚)CSDH患者临床资料.微导管均超选至MMA,使用Onyx-18 胶栓塞其主干及分支.出院后30、90 d影像随访评估血肿吸收情况,mRS评分较基线值降低≥1 分为临床症状改善.结果 14 例CSDH(17枚)患者MMA栓塞术均成功完成,无手术相关并发症发生.随访期所有患者症状及体征明显改善.11例患者 90d血肿量减少 90%以上,1 例 90d血肿量减少 40%以上,2 例 30d血肿量减少 30%以上.血肿完全吸收占比为 11/14,部分吸收占比为 3/14.结论 MMA介入栓塞治疗新发或复发性CSDH安全有效.
Objective To evaluate the safety and efficacy of interventional embolization of middle meningeal artery(MMA)for the treatment of chronic subdural hematoma(CSDH).Methods The clinical data of 14 patients with CSDH(17 lesions in total),who were treated with simple embolization of MMA at the Yijishan Hospital of Wannan Medical College of China between July 2021 and July 2022,were retrospective analyzed.After superselective catheterization of MMA using a microcatheter was accomplished,Onyx-18 glue,a liquid embolization agent,was used to embolize the main trunk and the branches of MMA.Imaging follow-up was adopted at 30 days and 90 days after discharge from hospital to evaluate the absorption of hematoma,and the improvement of clinical symptoms was defined as the modified Rankin Scale score(mRS)being decreased≥1 point from the baseline value.Results Successful embolization of MMA was accomplished for all the 17 lesions in the 14 patients,and no procedure-related complications occurred.During the follow-up period,the clinical symptoms and signs were remarkably improved in all patients.The postoperative 90-day hematoma volume was reduced by more than 90%in 11 patients and by more than 40%in one patient,and in 2 patients the postoperative 30-day hematoma volume was reduced by more than 30%.Complete absorption of hematoma was seen in 11 patients,and partial absorption of hematoma was observed in 3 patients.Conclusion For the treatment of newly-developed or recurrent CSDH,interventional embolization of MMA is clinically safe and effective.(J Intervent Radiol,2024,32:12-16)