Restricted accessCase reportFirst published online 2023
Middle meningeal artery embolization with polyvinyl alcohol particles in a patient with ophthalmic artery origin from middle meningeal artery: Case report and technical note
This is a case report of an adult with chronic subdural hematoma (cSDH) who underwent endovascular treatment for middle meningeal artery (MMA) embolization. There was a prominent meningo-ophthalmic branch with an absence of an ophthalmic artery from the internal carotid artery. MMA embolization was performed utilizing particles with no complications and the resolution of the cSDH was within 4 months. This case report demonstrates that despite extreme variant anatomy, MMA embolization with particles is feasible, effective, and safe when appropriate techniques are used.
NeifertSNChamanEKHardiganT, et al.Increases in subdural hematoma with an aging population-the future of American cerebrovascular disease. World Neurosurg2020; 141: e166–e174.
2.
LinkTWBodduSPaineSM, et al.Middle meningeal artery embolization for chronic subdural hematoma: a series of 60 cases. Neurosurgery2019; 85: 801–807.
3.
BaltUSA. The SQUID Trial for the Embolization of the Middle Meningeal Artery for Treatment of Chronic Subdural Hematoma (STEM). Clinical Trial Registration NCT04410146, clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT04410146 (9 November 2022, accessed 27 April 2023).
4.
Medtronic Neurovascular Clinical Affairs. A Study of the Embolization of the Middle Meningeal Artery With ONYXTM Liquid Embolic System In the Treatment of Subacute and Chronic Subdural HEmatoma (EMBOLISE). Clinical Trial Registration NCT04402632, clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT04402632 (16 March 2023, accessed 27 April 2023).
5.
BonasiaSSmajdaSCiccioG, et al.Middle meningeal artery: anatomy and variations. AJNR Am J Neuroradiol2020; 41: 1777–1785.
6.
FantoniMEliezerMSerranoF, et al.High frequency of ophthalmic origin of the middle meningeal artery in chronic subdural hematoma. Neuroradiology2020; 62: 639–644.
7.
MoussaviKMoussaviM. Abstract TP165: preventing ophthalmic complications by coiling the orbital anastomosis prior to middle meningeal artery embolization. Stroke2022; 53: ATP165–ATP165.
8.
KuJCDmytriwAAEssibayiMA, et al.Embolic agent choice in middle meningeal artery embolization as primary or adjunct treatment for chronic subdural hematoma: a systematic review and meta-analysis. AJNR Am J Neuroradiol2023; 44: 297–302.
