Liquid Embolic Volume Correlates With Improved Chronic Subdural Hematoma Resolution After Middle Meningeal Artery...

Area of Science:

• Neurosurgery
• Interventional Radiology
• Vascular Neurology

Background:

• Middle meningeal artery (MMA) embolization is effective for chronic subdural hematomas (cSDH).
• The impact of distal embolic penetration on cSDH resolution is debated.
• This study investigates technical factors influencing cSDH clearance after MMA embolization.

Purpose of the Study:

• To evaluate the effect of embolized MMA branches and embolic material volume on cSDH radiographic resolution.
• To compare outcomes between patients with single versus multiple distal MMA branch embolization.

Main Methods:

• Retrospective review of 131 MMA embolizations for cSDH treatment.
• Comparison of baseline characteristics and technical parameters (branches embolized, embolic volume) between resolved and persistent cSDH.
• Univariate statistical analysis to determine significant factors.

Main Results:

• 70 out of 131 (53.4%) cSDH cases achieved complete radiographic resolution.
• Older age, kidney disease, and larger subdural size were associated with persistent cSDH.
• Embolic material volume, but not the number of embolized MMA branches, significantly correlated with cSDH resolution (P = .04).

Conclusions:

• Embolic material volume is a significant predictor of radiographic cSDH resolution post-MMA embolization.
• The number of embolized MMA branches does not influence cSDH resolution rates.
• Future procedural optimization should consider embolic volume and targeted MMA branch selection to improve cSDH clearance.