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.
Le texte complet de cet article est disponible en PDF.Keywords : Cancer, Cone-beam computed tomography, Embolization, Interventional radiology, Middle meningeal artery
Abbreviations : 3D, CBCT, CT, FT, IQR, KAP, MMA, MMAE, RD, SDH
Plan
Vol 104 - N° 7-8
P. 368-372 - juillet 2023 Retour au numéro
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