{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:01:06Z","timestamp":1790694066190,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"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":["Interv Neuroradiol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Middle meningeal artery embolization (MMAE) has become a pivotal intervention in managing chronic subdural hematomas (cSDHs). This systematic review synthesizes past, recent, and ongoing clinical trials to assess MMAE's role in cSDH treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted using PRISMA guidelines, incorporating PubMed, ClinicalTrials.gov, and reverse bibliography searches to identify clinical trials evaluating MMAE for cSDH. Inclusion criteria included randomized and nonrandomized trials reporting outcomes, such as recurrence rates and procedural safety. Case reports, retrospective reviews, and opinion pieces were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven published and 15 ongoing trials were identified. Landmark randomized controlled trials (RCTs), including EMBOLISE, STEM, and MAGIC-MT, demonstrated reductions in hematoma recurrence and surgical rescues with MMAE, establishing its role as both an adjunctive and standalone therapy. Ongoing trials, such as EMPROTECT and CHESS, investigate diverse embolic agents, procedural strategies, and patient populations to optimize MMAE outcomes. However, challenges remain, including variability in patient selection criteria, embolic materials, and endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MMAE is an innovative and minimally invasive approach that has reshaped cSDH management. Evidence supports its efficacy and safety as an adjunct to surgery and a potential standalone therapy for select patients. Future research should focus on long-term outcomes, subgroup analyses, and standardization of protocols to further refine its application and integration into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251329970","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T08:05:18Z","timestamp":1743753918000},"page":"2899-2908","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["2024 middle meningeal artery embolization trials: A comprehensive review of past, recent, and ongoing trials"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-9413","authenticated-orcid":false,"given":"Avi A","family":"Gajjar","sequence":"first","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-4607","authenticated-orcid":false,"given":"Ali","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6646-3166","authenticated-orcid":false,"given":"John Y","family":"Chen","sequence":"additional","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Custozzo","sequence":"additional","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S","family":"Boulos","sequence":"additional","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C","family":"Dalfino","sequence":"additional","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-196X","authenticated-orcid":false,"given":"Nicholas C","family":"Field","sequence":"additional","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8315-5870","authenticated-orcid":false,"given":"Alexandra R","family":"Paul","sequence":"additional","affiliation":[{"name":"Albany Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyaa379"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2313472"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2409845"},{"key":"e_1_3_3_5_2","unstructured":"Bell J. Recent breakthroughs in cSDH intervention may lead to \u201cHERMES-style collaborative.\u201d NeuroNews International https:\/\/neuronewsinternational.com\/recent-breakthroughs-in-csdh-intervention-may-lead-to-hermes-style-collaborative\/ (2024 accessed 2 December 2024)."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000438774"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.13647"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30407-6"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.045871"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-015421"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401201"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06506-3"},{"key":"e_1_3_3_14_2","unstructured":"Bell J. MEMBRANE becomes latest RCT to demonstrate MMA embolisation\u2019s benefits in cSDH treatment. NeuroNews International https:\/\/neuronewsinternational.com\/membrane-becomes-latest-rct-to-demonstrate-mma-embolisations-benefits-in-csdh-treatment\/ (2024 accessed 2 December 2024)."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.4.0686"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.4103\/2152-7806.73801"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-010-0891-3"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199040100S218"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.10.035"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2019.105464"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.09.130"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.12.138"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyy521"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1591019919843354"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000003218"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-021880"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000002874"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2023-020907"},{"key":"e_1_3_3_29_2","first-page":"159101992311626","article-title":"Middle meningeal artery embolization as a perioperative adjunct to surgical evacuation of nonacute subdural hematomas: an multicenter analysis of safety and efficacy","author":"Salah WK","year":"2023","unstructured":"Salah WK, Baker C, Scoville JP, et al. Middle meningeal artery embolization as a perioperative adjunct to surgical evacuation of nonacute subdural hematomas: an multicenter analysis of safety and efficacy. Interv Neuroradiol 2023: 15910199231162665. doi:https:\/\/doi.org\/10.1177\/15910199231162665","journal-title":"Interv Neuroradiol"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000003023"},{"key":"e_1_3_3_31_2","unstructured":"Bell J. Recent breakthroughs in cSDH intervention may lead to \u201cHERMES-style collaborative.\u201d NeuroNews International https:\/\/neuronewsinternational.com\/recent-breakthroughs-in-csdh-intervention-may-lead-to-hermes-style-collaborative\/ (2024 accessed 2 December 2024)."},{"key":"e_1_3_3_32_2","unstructured":"Acevedo JMR. Puerto Rico Embolization of the Middle Meningeal Artery for the Treatment of Chronic Subdural Hematoma Trial (PREMMA). clinicaltrials.gov https:\/\/clinicaltrials.gov\/study\/NCT06466733 (2024 accessed 2 December 2024)."},{"key":"e_1_3_3_33_2","unstructured":"NeuroNews [@NN_publishing]. EMPROTECT study results presented by Eimad Shotar at #ESMINT2024 indicate comparable six-month post-surgery cSDH recurrence rates and similar adverse event rates between MMA embolisation using EMBOSPHERE particles (@MeritMedical) and best medical treatment @esmintsociety https:\/\/t.co\/t9oxiXCePp. Twitter https:\/\/x.com\/NN_publishing\/status\/1831275702630375695 (2024 accessed 2 December 2024)."},{"key":"e_1_3_3_34_2","unstructured":"Spahn J. Chronic Subdural Hematoma Treatment With Embolization Versus Surgery Study. clinicaltrials.gov https:\/\/clinicaltrials.gov\/study\/NCT06347796 (2024 accessed 2 December 2024)."},{"key":"e_1_3_3_35_2","unstructured":"Gentric J-C. LEADH: Efficacy of a Minimally Invasive Therapy Adjuvant to the Standards of Care by Cyanoacrylate Embolization\u202f: Liquid Embolic Agent for the Treatment of Chronic subDural Hematoma a Randomized Control Study. clinicaltrials.gov https:\/\/clinicaltrials.gov\/study\/NCT05374681 (2024 accessed 2 December 2024)."},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.3171\/2021.5.JNS21109"},{"key":"e_1_3_3_37_2","article-title":"Embolization of the middle meningeal artery for the prevention of chronic subdural hematoma recurrence in high-risk patients: a randomized controlled trial-the EMPROTECT study protocol","volume":"17","author":"Shotar E","year":"2024","unstructured":"Shotar E, Mathon B, Rouchaud A, et al. Embolization of the middle meningeal artery for the prevention of chronic subdural hematoma recurrence in high-risk patients: a randomized controlled trial-the EMPROTECT study protocol. 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