{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:34:18Z","timestamp":1786653258979,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["5U54GM104942-08"],"award-info":[{"award-number":["5U54GM104942-08"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"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) has recently emerged as a promising adjunctive therapy to surgical evacuation for patients with chronic subdural hematoma (cSDH). However, the optimal timing of MMAE relative to surgery remains poorly defined. Therefore, this large retrospective cohort study aimed to assess the impact of MMAE timing (preoperative vs. postoperative) on 6-month outcomes in patients with cSDH, focusing on rates of repeat surgery and mortality. We hypothesized that preoperative MMAE would be associated with lower rates of reoperation compared to postoperative MMAE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients with nontraumatic cSDH who underwent surgery with adjunctive MMAE were identified using ICD-10 codes from the TriNetX database. A 1:1 propensity score matching approach was used to balance baseline characteristics between groups. The primary outcomes were repeat surgery and all-cause mortality within 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 338 matched patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009338; 169 in each group) were included in the final analysis. Preoperative MMAE was associated with significantly lower odds of repeat surgery compared to postoperative MMAE (7.1% vs. 17.8%; OR 0.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). No significant difference was observed in 6-month all-cause mortality between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative MMAE is associated with reduced odds of repeat surgery compared to postoperative MMAE at 6 months. These findings support consideration of MMAE timing in surgical planning. Further prospective studies are warranted to validate these results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251372487","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T12:24:28Z","timestamp":1756815868000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Preoperative middle meningeal artery embolization is associated with reduced reoperation rates in chronic subdural hematoma"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5208-8425","authenticated-orcid":false,"given":"Hamza Adel","family":"Salim","sequence":"first","affiliation":[{"name":"Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA"},{"name":"Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3711-3626","authenticated-orcid":false,"given":"Waseem","family":"Shehadeh","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6771-193X","authenticated-orcid":false,"given":"Orabi","family":"Hajjeh","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, Harvard University, Boston, MA, USA"},{"name":"Neurovascular Centre, Departments of Medical Imaging and Neurosurgery, St Michael's Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2455-748X","authenticated-orcid":false,"given":"Huanwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Neurointerventional Surgery, Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8325-2382","authenticated-orcid":false,"given":"Muhammed Amir","family":"Essibayi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimer","family":"Adeeb","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Msherghi","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7823-3088","authenticated-orcid":false,"given":"Marco","family":"Colasurdo","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Oregon Health and Science University, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yale New Haven Hospital, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2450-4014","authenticated-orcid":false,"given":"Vivek S","family":"Yedavalli","sequence":"additional","affiliation":[{"name":"Department of 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