O-021 Concurrent middle meningeal artery embolization for treatment of chronic subdural hematomas
Notice bibliographique
Résumé
<h3></h3> Non-acute subdural hematomas (NASHs) are expected to be the most common cranial neurosurgery pathology encountered by the year 2030. Treatment with surgical evacuation may be necessary, but the rate of recurrence after surgical intervention has been reported to be as high as 30%. Minimally invasive middle meningeal artery embolization (MMAe) during the perioperative period has been posited as an adjunctive treatment to decrease recurrence after surgical evacuation of NASH. The authors evaluated the safety and efficacy of MMAe in a multi-institutional cohort. Data from 145 patients with NASH who underwent surgical evacuation and concurrent MMA embolization in the perioperative period were retrospectively collected from 15 institutions. The primary outcome was rates of NASH recurrence requiring repeat surgical intervention. We collected clinical data including use of anticoagulants and/or antiplatelets, prior treatment of NASH, and perioperative platelet counts; treatment data including anesthesia type, type of embolic agent, length of hospital stay, and access type; and radiographic data including laterality of the NASH, presence of subdural membranes, MMA size, presence of dangerous collaterals, and median width of the NASH at initial presentation, after evacuation, and at 90-day follow-up. This data can be seen in table 1. Radiographic features of the NASHs at last follow-up were included size reductions/improvements. Radiographic features at last follow-up are summarized in table 2. Outcomes data collected included: mortality, adverse events, and modified Rankin Scale (mRS) score at last follow-up, results can be seen in table 3. The median preoperative hematoma width was 18 mm, and subdural membranes were present on imaging in 87% of patients. At 90-day follow-up, the median NASH width was 6 mm, and 51% of patients had at least a 50% decrease of NASH size. At last clinical follow up, 87% had the same or improved mRS score. Eight percent of treated NASHs had recurrence requiring additional surgery. The total all-cause mortality was 6%. This study provides evidence from a multi-institutional cohort that performing concurrent MMAe in the perioperative period as an adjunct to surgical evacuation is a safe and effective means to reduce surgical recurrence in patients with NASHs. <h3>Disclosures</h3> <b>W. Salah:</b> None. <b>C. Baker:</b> None. <b>J. Scoville:</b> None. <b>J. Hunsaker:</b> None. <b>C. Ogilvy:</b> None. <b>J. Moore:</b> None. <b>H. Riina:</b> None. <b>E. Levy:</b> None. <b>A. Spiotta:</b> None. <b>B. Jankowitz:</b> None. <b>C. Cawley:</b> None. <b>A. Khalessi:</b> None. <b>O. Tanweer:</b> None. <b>R. Hanel:</b> None. <b>B. Gross:</b> None. <b>O. Kuybu:</b> None. <b>A. Nguyen Hoang:</b> None. <b>A. Baig:</b> None. <b>M. Khorasanizadeh:</b> None. <b>A. Mendez:</b> None. <b>G. Cortez:</b> None. <b>J. Davies:</b> None. <b>S. Narayanan:</b> None. <b>B. Howard:</b> None. <b>M. Lang:</b> None. <b>A. Siddiqui:</b> None. <b>A. Thomas:</b> None. <b>P. Kan:</b> None. <b>J. Burkhardt:</b> None. <b>M. Salem:</b> None. <b>R. Grandhi:</b> None.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».