E-267 Statin therapy does not influence the speed of chronic subdural hematoma resolution after middle meningeal artery embolization: single-center experience

Introduction

Statins have been proposed to improve resolution of chronic subdural hematomas (cSDH) after surgical evacuation. To the best of our knowledge, this effect has not been investigated yet in cSDHs treated solely with middle meningeal artery (MMA) embolization. In this study, we evaluate non-trial patients with cSDH treated with MMA embolization alone at our institution, aiming to compare the speed of resolution between patients with and without statin therapy.

Methods

We retrospectively searched our center's database of cSDHs. We included patients treated with MMA embolization alone, without previous or subsequent surgical evacuation, who were not enrolled in ongoing clinical trials. Information extracted were demographics, use of antithrombotic medications (anticoagulants and/or antiplatelets), use of statins, and angiographic follow-up. Patients and cSDHs were divided into statin and non-statin groups. Measurement of cSDH was based on non-contrast CT and the formula (maximal axial length x maximal thickness x maximal coronal height)/2. Volume (in millimeters, [mL]) was registered for baseline (immediately prior to embolization), and all subsequent scans available, being performed by 2 independent adjudicators. Volume reduction was defined as the difference between baseline and last available imaging follow-up volumes. Speed of resolution was calculated by dividing the volume reduction by the time length of imaging follow-up available.

Results

Forty-eight patients (statin group, 16 vs non-statin group, 32) with 50 cSDHs (statin 17, vs non-statin 33) were included. The groups were similar in mean age (statin, 75.8 years vs non-statin, 71.2 years, P=0.248), proportion of males (statin, 41.2% vs non-statin, 36.4%, P=0.890) and use of antithrombotic medications (statin, 29.4% vs non-statin, 24.2%, P=0.741). Median volumes were similar (statin, 29.8mL vs non-statin, 32mL, P=0.888). There was no significant difference in time lengths of imaging follow-up (statin, 71 days vs non-statin, 93 days P=0.401). Median final volume was also similar (statin, 2mL vs non-statin 1mL, P=0.542). Median volume reduction was similar (statin, 23mL vs non-statin, 23.7mL, P=0.959). The median speed of cSDH resolution was not significantly different between the groups (statin, 0.294mL/day vs non-statin, 0.187mL/day, P=0.442). Sub analysis of patients who were not on antithrombotic medications revealed similar findings.

Conclusions

Statin therapy was not associated with a significantly faster speed of cSDH resolution in our experience.

Disclosures

S. Housley: None. A. Monteiro: None. B. Donnelly: None. W. Khawar: None. M. Siddiqi: None. M. Waqas: None. J. Cappuzzo: None. A. Siddiqui: 2; C; Amnis Therapeutics, Apellis Pharmaceuticals, Inc., Boston Scientific, Canon Medical Systems USA, Inc., Cardinal Health 200, LLC, Cerebrotech Medical Systems, Inc., Cerenovus, Cerevatech Medical, Inc.,. 4; C; Adona Medical, Inc., Amnis Therapeutics, Bend IT Technologies, Ltd., BlinkTBI, Inc, Buffalo Technology Partners, Inc., Cardinal Consultants, LLC, Cerebrotech Medical Systems, Inc, Cerevatech Medical,. E. Levy: 2; C; Claret Medical, GLG Consulting, Guidepoint Global, Imperial Care, Medtronic, Rebound, StimMed, Misionix, Mosiac, Clarion, IRRAS.. 4; C; NeXtGen Biologics, RAPID Medical, Claret Medical, Cognition Medical, Imperative Care, Rebound Therapeutics, StimMed, Three Rivers Medical. J. Davies: 1; C; NIH NINDS, NSF SBIR. 2; C; Medtronic.