{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:51:55Z","timestamp":1777729915710,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Middle meningeal artery embolization (MMAE) is a promising treatment for chronic subdural hematoma (cSDH). Cancer patients are at risk for cSDH due to thrombocytopenia. The efficacy of MMAE in this population has not been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 76 patients who underwent 94 MMAEs for cSDH at 12 tertiary centers across North America and Europe between February 2018 and January 2023. We analyzed patient demographics, clinical profiles, procedural details, and outcomes. The primary outcome was cSDH progression, while secondary outcomes included radiographic resolution, mortality, 90-day functional outcomes, functional improvement, and procedural complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Radiographic improvement occurred in 88.5% of patients, and technical success was achieved in 96.8%, with comparable rates between the MMAE-only and MMAE\u2009+\u2009surgery groups. Complications occurred in five patients (5.3%), with no significant difference between groups (6.0% in MMAE vs. 3.7% in MMAE\u2009+\u2009surgery,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.658). Hemorrhage was reported in four patients (4.3%), and no cases of stroke were recorded. Mortality was 24.5% overall, with a slightly higher rate in the MMAE\u2009+\u2009surgery group (29.6%) compared to the MMAE-only group (22.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.460). Functional improvement in modified Rankin Scale (mRS) was seen in 15 patients (24.2%), with a significantly greater improvement in the combined group (\u0394 mRS\u2009=\u20092.625) versus the MMAE-only group (\u0394 mRS\u2009=\u20090.348,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MMAE is a safe and effective treatment option for managing cSDH in cancer patients. Higher mortality in this population is likely reflective of underlying cancer and comorbidities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251341650","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T03:42:28Z","timestamp":1747107748000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["International multi-center study of middle meningeal artery embolization for chronic subdural hematoma in cancer patients: Efficacy, safety, and outcomes in a high-risk population"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-9413","authenticated-orcid":false,"given":"Avi A","family":"Gajjar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA"},{"name":"Department of Neurosurgery, Albany Medical Center, Albany, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed M","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA"},{"name":"Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios S","family":"Sioutas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashad","family":"Jabarkheel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0655-5755","authenticated-orcid":false,"given":"Okkes","family":"Kuybu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Khalife","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Cortez","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular and Endovascular Surgery, Baptist Neurological Institute and Lyerly Neurosurgery, Jacksonville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0131-5699","authenticated-orcid":false,"given":"Adam A","family":"Dmytriw","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital &amp; Brigham and Women's Hospital, Harvard University, Boston, MA, USA"},{"name":"Neurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, ON, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego Alejandro","family":"Ortega Moreno","sequence":"additional","affiliation":[{"name":"Neurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, ON, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Smith","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital &amp; Brigham and Women's Hospital, Harvard University, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W","family":"Regenhardt","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital &amp; Brigham and Women's Hospital, Harvard University, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate T","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":"Juan Francisco","family":"Ruiz Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7871-9539","authenticated-orcid":false,"given":"Oleg","family":"Shekhtman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex Nguyen","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander A","family":"Khalessi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California-San Diego, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cordell","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Matejka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole M","family":"Cancelliere","sequence":"additional","affiliation":[{"name":"Neurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, ON, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2952-3812","authenticated-orcid":false,"given":"Christoph J","family":"Griessenauer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9000-6083","authenticated-orcid":false,"given":"Ramesh","family":"Grandhi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Kan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA"},{"name":"Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, 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":"Michael R","family":"Levitt","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital &amp; 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