Minimally Invasive Procedure Halves Risk of Recurrent Brain Bleeds
Middle Meningeal Artery Embolization Cuts Treatment Failure by 47 Percent Compared to Standard Care Alone
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Middle meningeal artery embolization (MMAE), a minimally invasive procedure, significantly reduces recurrence and reoperation rates in patients with chronic subdural hematoma (cSDH), one of the most common neurosurgical conditions affecting older adults, according to a new study published in JAMA Neurology and co-authored by Fawaz Al-Mufti, M.D., professor of neurology, neurosurgery, and of radiology at New York Medical College.
“Traditional treatment has involved open surgical evacuation or burr-hole drainage of the bleed. However, because the surrounding membranes remain inflamed, up to 30 percent of patients experience a recurrent bleed,” says Dr. Al-Mufti. “We wanted to test if adding middle meningeal artery embolization could safely stop that cycle. The results were striking—cutting treatment failure by 47 percent compared to standard care alone.”
For the trial, the researchers enrolled 376 patients across 30 international hospitals to test MMAE using a liquid embolic agent (n-BCA). Adding MMAE to standard treatment reduced blood re-accumulation or the need for follow-up surgery from 22.1 percent down to 11.6 percent over six months (a 47 percent reduction in odds). Only 3.8 percent of patients who received MMAE needed a subsequent surgical procedure, compared to 10 percent of patients who received standard care alone.
“In addition to dramatically reducing repeat bleeds, MMAE proved to be exceptionally safe,” says Dr. Al-Mufti. “Adverse event rates were comparable to standard care without compromising functional recovery or quality of life in our treatment group. While further research will help us continuously monitor long-term outcomes, this study represents a major step forward for patient safety and recovery.”
