Angiographic Anatomy of the Middle Meningeal Artery in Relation to Chronic Subdural Hematoma Embolization

Shotar, Eimad; Premat, Kévin; Lenck, Stéphanie; Degos, Vincent; Marijon, Pauline; Pouvelle, Arnaud; Pouliquen, G.; Mouyal, Samuel; Jaoudé, Samiya Abi; Sourour, Nader‐Antoine; Mathon, Bertrand; Clarençon, Frédéric

doi:10.1007/s00062-021-00996-5

Cited by 15 publications

(11 citation statements)

References 27 publications

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“…Complications: Access artery occlusion is rare but remains a concern [ 22 ]. Kan et al (2020) evaluated a multicenter series of 154 MMA embolizations.…”

Section: Discussionmentioning

confidence: 99%

“…Rather an interesting phenomenon than a significant complication is the de novo occurrence of a DAVF several months after the particle embolization of both MMAs [ 22 ]. The “DAVFs” described by Piergallini et al (2019) occurred immediately after the particle embolization through large microcatheters (Headway 27, MicroVention).…”

Section: Discussionmentioning

confidence: 99%

“…In several studies and meta-analyses, the recurrence rate was higher in operated than embolized patients [ 19 , 22 , 52 , 62 ]. In a study by Schwarz et al (2021), the combined surgery and subsequent embolization resulted in a need for a second operation in only 4.5% [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…The anterior and posterior branches of the MMA have been identified angiographically. The petrous branch of the MMA and vessels from which EC-IC collaterals exist were not embolized [ 2 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

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Endovascular Treatment of Chronic Subdural Hematomas through Embolization: A Pilot Study with a Non-Adhesive Liquid Embolic Agent of Minimal Viscosity (Squid)

Петров

Ivanov

Рожченко

et al. 2021

JCM

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Objective: Endovascular embolization using non-adhesive agents (e.g., ethylene vinyl alcohol copolymer with suspended micronized tantalum dissolved in dimethyl sulfoxide; Squid, Balt Extrusion) is an established treatment of brain arteriovenous malformations, dural arteriovenous fistulas, and hypervascular neoplasms. Middle meningeal artery (MMA) embolization is a relatively new concept for treating chronic subdural hematomas (CSDH). This study aimed to evaluate the safety and effectiveness of the use of Squid in the endovascular treatment of CSDH. Methods: Embolization was offered to patients with CSDH with minimal or moderate neurological deficits and patients who had previously undergone open surgery to evacuate their CSDH without a significant effect. Distal catheterization of the MMA was followed by embolization of the hematoma capsule with Squid 12 or Squid 18. Safety endpoints were ischemic or hemorrhagic stroke and any other adverse event of the endovascular procedure. Efficacy endpoints were the feasibility of the intended procedure and a ≥ 50% reduction of the maximum depth of the CSDH confirmed by follow-up computed tomography (CT) after >3 months. Results: Between November 2019 and July 2021, 10 patients (3 female and 7 male, age range 42–89 years) were enrolled. Five patients had bilateral hematomas, and five patients had previously been operated on with no significant effect and recurrent hematoma formation. The attempted embolization was technically possible in all patients. No technical or clinical complication was encountered. During a post-procedural follow-up (median 90 days), 10 patients improved clinically. A complete resolution of the CSDH was observed in 10 patients. The clinical condition of all enrolled patients during the so-far last contact was rated mRS 0 or 1. Conclusion: A distal catheterization of the MMA for the endovascular embolization of CSDH with Squid allowed for the devascularization of the MMA and the dependent vessels of the hematoma capsule. This procedure resulted in a partial or complete resolution of the CSDH. Procedural complications were not encountered.

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“…Complications: Access artery occlusion is rare but remains a concern [ 22 ]. Kan et al (2020) evaluated a multicenter series of 154 MMA embolizations.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Endovascular Treatment of Chronic Subdural Hematomas through Embolization: A Pilot Study with a Non-Adhesive Liquid Embolic Agent of Minimal Viscosity (Squid)

Петров

Ivanov

Рожченко

et al. 2021

JCM

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“…It enters the floor of middle cranial fossa through foramen spinosum, travels latterly through a middle fossa bony ridge and curves anteriorly over upper greater a wing of sphenoid where it divides into frontal and parietal branch [16,17]. Frontal branch is located in a Bonny tunnel and is susceptible to tearing during trauma and this can produce many neurological disorders [18,19]. The knowledge and awareness of these anatomic variations becomes important for surgeons to reduce risk of complication during surgical repair.…”

Section: Introductionmentioning

confidence: 99%

A Study on Branching Pattern of Branches of Middle Meningeal Artery Based on Meningeal Grooves Present in the Cranial Cavity in South Indian Dry Skulls

Sushmitha¹,

Premavathy

2021

JPRI

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Aim: To study the branching pattern of branches of the middle meningeal artery based on meningeal grooves present in the cranial cavity. Introduction: Middle meningeal artery is the major human dural artery. It is a neurologically very important artery for treatment and study of various neural health problems. Its origin and course can vary a lot in relation with embryological development. Complex sequences of MMA gives many opportunities for variant anatomy. It is clinically very important. Materials and Methods: In this study we decided to investigate the anatomical organisation of the MMA, its branching pattern by taking south indian human dry skulls (N=30). It can be easily traced next to foramen spinosum. The statistical analysis was performed using the t-test calculator. Results: Most of the skulls had its middle branch of MMA from the anterior branch. There were many variations observed in the branching pattern. Conclusion: The branching pattern had many anatomical variations, which differed from one skull to another. The future scope of this study is to analyse skulls of people from different ethnical groups, observe the variations and trace the correlations.

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A systematic review of middle meningeal artery embolization for minimally symptomatic chronic subdural haematomas that do not require immediate evacuation

Rojas-Villabona,

Mohamed,

Kennion

et al. 2023

Brain and Spine

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Angiographic Anatomy of the Middle Meningeal Artery in Relation to Chronic Subdural Hematoma Embolization

Cited by 15 publications

References 27 publications

Endovascular Treatment of Chronic Subdural Hematomas through Embolization: A Pilot Study with a Non-Adhesive Liquid Embolic Agent of Minimal Viscosity (Squid)

Endovascular Treatment of Chronic Subdural Hematomas through Embolization: A Pilot Study with a Non-Adhesive Liquid Embolic Agent of Minimal Viscosity (Squid)

A Study on Branching Pattern of Branches of Middle Meningeal Artery Based on Meningeal Grooves Present in the Cranial Cavity in South Indian Dry Skulls

A systematic review of middle meningeal artery embolization for minimally symptomatic chronic subdural haematomas that do not require immediate evacuation

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