{"doi":"10.1161/svin.125.001871","title":"Impact of Antivascular Endothelial Growth Factor Therapy in Chronic Subdural Hematoma Patients: A Propensity-Matched Multi-Institutional Cohort Study","abstract":"BACKGROUND: To evaluate possible associations between anti-VEGF (vascular endothelial growth factor) therapy and cSDH (chronic subdural hematoma) outcomes. METHODS: We conducted a cohort study using the TriNetX Research Network, comparing patients with cSDH taking anti-VEGF agents to controls through propensity score matching. Outcomes measured were assessed at 6 months and 1 year follow-up and included cSDH rebleeding, endovascular or surgical cSDH treatment, mortality, headaches, stroke, arterial hypertension, proteinuria, and major bleeding (noncranial). RESULTS: After propensity matching, 737 patients were included in both anti-VEGF and control cohorts at 6 months, and 722 patients in each cohort at 1 year. Baseline characteristics were well balanced. At 6-months, the anti-VEGF group had significantly lower odds of rebleeding (odds ratio [OR], 0.204 [95% CI, 0.159–0.26]; P <0.001), craniotomy (OR, 0.340 [95% CI, 0.155–0.680]; P =0.002), and mortality (OR, 0.778 [95% CI, 0.615–0.990]; P =0.037). At 1-year, reduced odds persisted for rebleeding (OR, 0.158 [95% CI, 0.122–0.200]; P <0.001), craniotomy (OR, 0.250 [95% CI, 0.116–0.490]; P <0.001), embolization (OR, 0.380 [95% CI, 0.172–0.770]; P =0.007), and mortality (OR, 0.677 [95% CI, 0.520–0.880]; P =0.003). Arterial hypertension was higher in the anti-VEGF group at 6 months (OR, 1.240 [95% CI, 1.000–1.530]; P =0.048), but not 1 year (OR, 1.110 [95% CI, 0.904–1.350]; P =0.330). No significant differences were observed in headache, stroke, proteinuria, or major bleeding at either time point. CONCLUSIONS: Anti-VEGF therapy is associated with significantly reduced rebleeding, reintervention rates, and mortality in patients with cSDH at both 6 months and 1 year. A transient increased incidence of arterial hypertension was noted at 6 months, but other major adverse events were not significantly different. Further randomized, prospective studies are warranted to confirm these results and optimize treatment strategies.","journal":"Stroke Vascular and Interventional Neurology","year":2025,"id":585352,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9199,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1177881,"name":"Sean O’Leary","orcid":"0000-0003-3650-705X","position":1,"is_corresponding":false},{"id":298076,"name":"Christopher C. Young","orcid":"0000-0002-3679-3212","position":2,"is_corresponding":false},{"id":298055,"name":"Peter Kan","orcid":"0000-0001-6649-4128","position":3,"is_corresponding":false},{"id":1410982,"name":"Matías Costa","orcid":"0000-0003-1833-4589","position":0,"is_corresponding":true}],"reference_count":66,"raw_metadata":null,"created_at":"2026-07-19T02:59:20.067334Z","pmid":"41503088","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}