{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:43:58Z","timestamp":1777927438899,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n                    Middle meningeal artery embolization (MMAE) is emerging as a safe and effective standalone intervention for non-acute subdural hematomas (NASHs); however, the risk of hematoma recurrence after MMAE in coagulopathic patients is unclear. To characterize the impact of coagulopathy on treatment outcomes, we analyzed a multi-institutional database of patients who underwent standalone MMAE as treatment for NASH. We classified 537 patients who underwent MMAE as a standalone intervention between 2019 and 2023 by coagulopathy status. Coagulopathy was defined as use of anticoagulation\/antiplatelet agents or pre-operative thrombocytopenia (platelets &lt;100,000\/\u03bcL). Demographics, pre-procedural characteristics, in-hospital course, and patient outcomes were collected. Thrombocytopenia, aspirin use, antiplatelet agent use, and anticoagulant use were assessed using univariate and multivariate analyses to identify any characteristics associated with the need for rescue surgical intervention, mortality, adverse events, and modified Rankin Scale score at 90-day follow-up. Propensity score-matched cohorts by coagulopathy status with matching covariates adjusting for risk factors implicated in surgical recurrence were evaluated by univariate and multivariate analyses. Minimal differences in pre-operative characteristics between patients with and those without coagulopathy were observed. On unmatched and matched analyses, patients with coagulopathy had higher rates of requiring subsequent surgery than those without (unmatched: 9.9% vs. 4.3%; matched: 12.6% vs. 4.6%; both\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05). On matched multivariable analysis, patients with coagulopathy had an increased odds ratio (OR) of requiring surgical rescue (OR 3.95; 95% confidence interval [CI] 1.68\u20139.30;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Antiplatelet agent use (ticagrelor, prasugrel, or clopidogrel) was also predictive of surgical rescue (OR 4.38; 95% CI 1.51\u201312.72;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.01), and patients with thrombocytopenia had significantly increased odds of in-hospital mortality (OR 5.16; 95% CI 2.38\u201311.20;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01). There were no differences in follow-up radiographic and other clinical outcomes in patients with and those without coagulopathy. Patients with coagulopathy undergoing standalone MMAE for treatment of NASH may have greater risk of requiring surgical rescue (particularly in patients using antiplatelet agents), and in-hospital mortality (in thrombocytopenic patients).\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0413","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T02:42:40Z","timestamp":1710384160000},"page":"1375-1383","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["The Influence of Coagulopathy on Radiographic and Clinical Outcomes in Patients Undergoing Middle Meningeal Artery Embolization as Standalone Treatment for Non-acute Subdural Hematomas"],"prefix":"10.1177","volume":"41","author":[{"given":"Walid K.","family":"Salah","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA."},{"name":"School of Medicine, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew C.","family":"Findlay","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cordell M.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan P.","family":"Scoville","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael T.","family":"Bounajem","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher S.","family":"Ogilvy","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin M.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard A.","family":"Riina","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NYU Langone Health, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elad I.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University at Buffalo, Buffalo, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan H.","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University at Buffalo, Buffalo, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro M.","family":"Spiotta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Michael","family":"Cawley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander A.","family":"Khalessi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California San Diego, La Jolla, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Tanweer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Hanel","sequence":"additional","affiliation":[{"name":"Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley A.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okkes","family":"Kuybu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian M.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex N.","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Houston Methodist, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ammad A.","family":"Baig","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University at Buffalo, Buffalo, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MirHojjat","family":"Khorasanizadeh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mount Sinai Icahn School of Medicine, New York, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo A.","family":"Mendez Ruiz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Cortez","sequence":"additional","affiliation":[{"name":"Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M.","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University at Buffalo, Buffalo, New York, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajith J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cooper University Healthcare, Camden, New Jersey, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cooper University Healthcare, Camden, New Jersey, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Khalife","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cooper University Healthcare, Camden, New Jersey, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios S.","family":"Sioutas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary A.","family":"Abecassis","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian T.","family":"Jankowitz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Ruiz Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Levitt","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter T.","family":"Kan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan-Karl","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Visish","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed M.","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh","family":"Grandhi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, 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