Embolization of Middle Meningeal Artery for Management of Chronic Subdural Hematoma

Author(s): Joshua Dian, James McEachern, Zul Kaderali, Joseph Silvaggio, Jai Shankar

Background: Embolization of middle meningeal artery (EMMA) has rapidly gained in popularity as a novel treatment for CSDH and as a method to decrease rates of CSDH recurrence. The purpose of our study is to report a single Canadian center experience of EMMA for the management of CSDH. Method: The consecutive patients undergoing EMMA during the period July 2020 to September 2021 at our tertiary care center were included in this series. EMMA procedures were performed using polyvinyl alcohol (PVA) particles or liquid embolic agent (LEA) based on the operators preference. All patients were followed clinically and radiographically as per standard of care. Patient demographic, clinical and imaging data were collected.
Results: A total of 19 patients (mean age - 65.6 years; range- 14-85 yrs; Male - 16) with CSDH underwent 20 EMMA procedures. None of these patients have peri-procedural complications related to EMMA. There was no recurrence of CSDH on the side treated with EMMA. The size of CSDH decreased in all patients on follow up.
Conclusion: In our small series with limited follow up, EMMA was found to be effective and safe in the management of CSDH with no periprocedural complications and no evidence of recurrence on the treated side.