A novel combination of surgery and embolization used to treat subdural hematomas, bleeding between the brain and its protective membrane due to trauma, reduces the risk of follow-up surgeries, according to researchers at Weill Cornell Medicine and University at Buffalo. Embolization is a minimally invasive procedure that blocks specific blood vessels to stop abnormal bleeding. The finding is based on EMBOLISE, a multi-center, randomized, clinical study that compared chronic subdural hematoma recurrence rates in patients treated with surgery and middle meningeal artery (MMA) embolization versus current standard of care with surgery alone.
The research, published Nov. 21 in the New England Journal of Medicine, found that hematoma recurrence or progression resulting in another surgery occurred in about 4% of patients who underwent MMA embolization plus surgery compared to more than 11% of those who received surgery alone. "This trial provides evidence that adding MMA embolization should be a new standard of care for one of the most common neurosurgical conditions we see," said co-lead author and pioneer of MMA embolization, Dr.
Jared Knopman, director of Cerebrovascular Surgery and Interventional Neuroradiology, an associate professor of neurological surgery at Weill Cornell Medicine and a neurosurgeon at NewYork-Presbyterian/Weill Cornell Medical Center. Already quite common in older adults, by 2030 chronic subdural hematomas are expected to be the most common cranial neurosurg.