脑膜中动脉栓塞术可有效治疗对阿托伐他汀耐药的慢性硬膜下血肿患者

IF 1.3 Q4 CLINICAL NEUROLOGY Brain Hemorrhages Pub Date : 2023-12-01 DOI:10.1016/j.hest.2023.08.001
Yin Niu , Zhouyang Jiang , Yujie Chen, Gang Zhu, Hua Feng, Zhi Chen
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引用次数: 0

摘要

目的 探讨阿托伐他汀治疗失败的 CSDH 患者接受 MMA 栓塞治疗的疗效和安全性。方法 纳入 2021 年 1 月 1 日至 2021 年 12 月 31 日阿托伐他汀治疗失败的 17 例 CSDH 患者。结果所有患者均成功栓塞了 26 个 MMA(8 例患者单侧栓塞,9 例患者双侧栓塞)。仅有一名患者(5.9%)在 MMA 栓塞后血肿再次积聚,并通过手术排出。未观察到手术不良事件、死亡率或并发症。在 MMA 栓塞术后平均 51.5 天的最后一次随访中,95.2% 的 CSDH 最大血肿厚度有所改善,平均减少 52.1%,94.1% 的患者 mRS 评分有所改善。此外,5 例(29.4%)单侧血肿患者接受了双侧 MMA 栓塞治疗,5 例患者的血肿均完全吸收。对于单侧 CSDH,双侧超选择性血管造影和双侧 MMA 栓塞术可能是一种有效的治疗策略。
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Middle meningeal artery embolization may be an effective treatment for patients with chronic subdural hematoma resistant to atorvastatin

Objective

To investigate the efficacy and safety of MMA embolization in patients with CSDH who failed atorvastatin treatment.

Methods

Seventeen CSDH patients who failed atorvastatin treatment from Jan 1, 2021 to Dec 31, 2021 were included in the study. All patients were treated with MMA embolization using polyvinyl alcohol (PVA) particles.

Results

Twenty-six MMAs (unilateral embolization in 8 patients and bilateral embolization in 9 patients) were successfully embolized in all patients. Hematoma re-accumulated in only one patient (5.9%) after MMA embolization and was surgically evacuated. Procedural adverse events, mortality, or complications were not observed. At the last follow-up of an average of 51.5 days post MMA embolization, maximum hematoma thickness improved in 95.2% of CSDHs with a mean reduction of 52.1%, while mRS score improved in 94.1% of patients. In addition, 5 (29.4%) patients with unilateral hematoma underwent bilateral MMA embolization and hematoma absorbed completely in all 5 cases.

Conclusions

MMA embolization may be a minimally invasive alternative to surgical evacuation for CSDH patients resistant to atorvastatin. In unilateral CSDH, bilateral superselective angiography and bilateral MMA embolization could be a useful and effective treatment strategy.

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来源期刊
Brain Hemorrhages
Brain Hemorrhages Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
52
审稿时长
22 days
期刊最新文献
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