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We report an early experience of intra\u2010arterial bevacizumab, a vascular endothelial growth factor receptor antagonist, to the middle meningeal artery of 12 hemispheres in 8 patients with cSDH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Eight patients with either unilateral or bilateral cSDH received intra\u2010arterial infusion of 2\u00a0mg\/kg bevacizumab into the middle meningeal artery of each treated hemisphere. The primary outcome was hematoma recurrence or reaccumulation requiring surgical drainage or middle meningeal artery embolization within 3 months posttreatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Of 12 hemispheres treated, no treatment\u2010related complications were reported. Median duration of follow\u2010up was 5 months (interquartile range 3\u20137.5). By 3 months posttreatment, no patients experienced hematoma recurrence or reaccumulation. One patient required concurrent evacuation at the time of bevacizumab administration. There were no major strokes or mortality within 3 months. Four hemispheres (33.3%) demonstrated complete radiographic hematoma resolution by 3 months. All hemispheres achieved 50% reduction in hematoma size by 3 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">For all hemispheres treated, there was no hematoma recurrence or progression requiring surgical drainage or middle meningeal artery embolization within 3 months except 1 who required concurrent evacuation 24 hours after treatment. Our initial experience supports bevacizumab as a novel, potentially viable agent for cSDH treatment in select patients. Future studies in larger cohorts are necessary to confirm efficacy and safety and appropriate dosing.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.124.001409","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T09:15:37Z","timestamp":1721726137000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Intra\u2010arterial Selective Bevacizumab Administration in the Middle Meningeal Artery for Chronic Subdural Hematoma: An Early Experience in 12 Hemispheres"],"prefix":"10.1161","volume":"4","author":[{"given":"Jane","family":"Khalife","sequence":"first","affiliation":[{"name":"Department of Neurology Cooper Neurological Institute Cooper University Health Care Camden NJ"},{"name":"Cooper Medical School of Rowan University Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Koneru","sequence":"additional","affiliation":[{"name":"Cooper Medical School of Rowan University Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Cooper Medical School of Rowan University Camden NJ"},{"name":"Department of Neurological Surgery Cooper Neurological Institute Cooper University Health Care Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza A.","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Cooper Medical School of Rowan University Camden NJ"},{"name":"Department of Neurological Surgery Cooper Neurological Institute Cooper University Health Care Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tudor G.","family":"Jovin","sequence":"additional","affiliation":[{"name":"Department of Neurology Cooper Neurological Institute Cooper University Health Care Camden NJ"},{"name":"Cooper Medical School of Rowan University Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratit D.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurology Cooper Neurological Institute Cooper University Health Care Camden NJ"},{"name":"Cooper Medical School of Rowan University Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4412-3152","authenticated-orcid":false,"given":"Ajith J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Cooper Medical School of Rowan University Camden NJ"},{"name":"Department of Neurological Surgery Cooper Neurological Institute Cooper University Health Care Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s10143-011-0349-y","article-title":"The surgical management of chronic subdural hematoma","volume":"35","author":"Ducruet AF","year":"2012","unstructured":"Ducruet AF, Grobelny BT, Zacharia BE, Hickman ZL, DeRosa PL, Andersen KN, Sussman E, Carpenter A, Connolly ES Jr. The surgical management of chronic subdural hematoma. 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