Middle meningeal artery embolization using cone-beam computed tomography augmented guidance in patients with cancer - 23/06/23
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Highlights |
• | Cone-beam computed tomography (CBCT) is a highly effective treatment option for middle meningeal artery embolization in patients with cancer. |
• | In patients with cancer, CBCT can be used for middle meningeal artery embolization to treat subdural hematoma with a favorable outcome. |
• | Middle meningeal artery embolization under CBCT guidance results in subdural hematoma size reduction greater than 50% in two thirds of patients with cancer with a low complication rate. |
Abstract |
Purpose |
The purpose of this study was to evaluate the safety and efficacy of middle meningeal artery embolization (MMAE) performed under cone-beam computed tomography (CBCT) augmented guidance in patients with cancer.
Materials and methods |
Eleven patients with cancer (seven women, four men; median age, 75 years; age range: 42–87 years) who underwent 17 MMAEs under CBCT with a combination of particles and coils for chronic subdural hematoma (SDH) (n = 6), postoperative SDH (n = 3), or preoperative embolization of meningeal tumor (n = 2) from 2022 to 2023 were included. Technical success, fluoroscopy time (FT), reference dose (RD), kerma area product (KAP) were analyzed. Adverse events and outcomes were recorded.
Results |
The technical success rate was 100% (17/17). Median MMAE procedure duration was 82 min (interquartile range [IQR]: 70, 95; range: 63–108 min). The median FT was 24 min (IQR: 15, 48; range: 21.5–37.5 min); the median RD was 364 mGy (IQR: 37, 684; range: 131.5–444.5 mGy); and the median KAP was 46.4 Gy.cm2 (9.6, 104.5; range: 30.2–56.6 Gy.cm2). No further interventions were needed. The adverse event rate was 9% (1/11), with one pseudoaneurysm at the puncture site in a patient with thrombocytopenia, which was treated by stenting. The median follow-up was 48 days (IQR; 14, 251; range: 18.5–91 days]. SDH reduced in 11 of 15 SDHs (73%) as evidenced by follow-up imaging, with a size reduction greater than 50% in 10/15 SDHs (67%) .
Conclusion |
MMAE under CBCT is a highly effective treatment option, but appropriate patient selection and careful consideration of potential risks and benefits is important for optimal patient outcomes.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Cancer, Cone-beam computed tomography, Embolization, Interventional radiology, Middle meningeal artery
Abbreviations : 3D, CBCT, CT, FT, IQR, KAP, MMA, MMAE, RD, SDH
Mappa
Vol 104 - N° 7-8
P. 368-372 - luglio 2023 Ritorno al numero
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