.webp&w=384&q=75){kind=logo}
Loading, please wait...
Loading, please wait...
This randomized trial investigated whether middle meningeal artery embolization added to standard surgical or nonsurgical treatment reduced treatment failure in 310 patients with symptomatic chronic subdural hematoma. Participants were assigned to embolization plus standard treatment (n=149) or standard treatment alone (n=161); the primary efficacy endpoint was a composite of residual or recurrent hematoma greater than 10 mm, reoperation or surgical rescue, or major disabling stroke, myocardial infarction, or neurological death within 180 days. In the primary efficacy analysis, treatment failure occurred in 19 of 120 patients (16%) receiving embolization compared with 47 of 129 (36%) receiving standard treatment alone, corresponding to an odds ratio of 0.36 (95% CI, 0.20–0.66; P=0.001) and an absolute difference of 20 percentage points. The primary safety endpoint of major disabling stroke or death within 30 days occurred in 4 of 144 patients (3%) in the embolization group and 5 of 166 (3%) in the control group. By 180 days, deaths had occurred in 12 patients (8%) receiving embolization and 9 (5%) receiving standard treatment; neurological deaths occurred in 1 patient (1%) and 3 patients (2%), respectively. These findings suggest that adjunctive embolization reduces treatment failure without a detected increase in the prespecified 30-day safety endpoint, although longer-term safety requires continued evaluation.
Read summarized clinical updates, watch expert medical content, and earn CME certifications right from your smartphone.
Open your smartphone camera to scan and install.
This randomized trial investigated whether middle meningeal artery embolization added to standard surgical or nonsurgical treatment reduced treatment failure in 310 patients with symptomatic chronic subdural hematoma. Participants were assigned to embolization plus standard treatment (n=149) or standard treatment alone (n=161); the primary efficacy endpoint was a composite of residual or recurrent hematoma greater than 10 mm, reoperation or surgical rescue, or major disabling stroke, myocardial infarction, or neurological death within 180 days. In the primary efficacy analysis, treatment failure occurred in 19 of 120 patients (16%) receiving embolization compared with 47 of 129 (36%) receiving standard treatment alone, corresponding to an odds ratio of 0.36 (95% CI, 0.20–0.66; P=0.001) and an absolute difference of 20 percentage points. The primary safety endpoint of major disabling stroke or death within 30 days occurred in 4 of 144 patients (3%) in the embolization group and 5 of 166 (3%) in the control group. By 180 days, deaths had occurred in 12 patients (8%) receiving embolization and 9 (5%) receiving standard treatment; neurological deaths occurred in 1 patient (1%) and 3 patients (2%), respectively. These findings suggest that adjunctive embolization reduces treatment failure without a detected increase in the prespecified 30-day safety endpoint, although longer-term safety requires continued evaluation.
Today
A bioengineered oral nanozyme microsupplement converts pathological ROS into a protective polydopamine hydrogel shield. By curbing neutrophil extracellular traps and balancing T cells, this platform outperforms standard 5-ASA in preclinical colitis models, opening new paths for sustained remission.
6 days back
Recent research reveals that downregulating YAP1/TAZ-TEAD via Hippo signaling triggers spontaneous human trophoblast syncytialization in 3D cultures, illuminating placental biology and preeclampsia.
4 weeks back
Abdominal aortic aneurysm rupture remains a catastrophic vascular emergency. Groundbreaking research reveals that USP53 accelerates aneurysm progression by reprogramming smooth muscle cell metabolism toward aerobic glycolysis, highlighting a promising target beyond conventional diameter-based surveillance.
Last week
A breakthrough study leverages natural language processing to accurately identify incident medication-related osteonecrosis of the jaw and track antiresorptive drug holidays from clinical narratives in electronic health records, advancing osteoporosis pharmacovigilance and dental safety.
Last week
Recent research defines ferro-aging as a conserved iron-lipid axis driving organ decline across primates. Age-related iron dyshomeostasis stimulates ACSL4-mediated lipid peroxidation, promoting cellular senescence. Notably, vitamin C directly inhibits ACSL4, suppressing phospholipid oxidation and multi-organ decay.
Last week
