Middle meningeal artery embolization and subdural evacuating port system placement for chronic subdural hematomas: how I do it
Abstract
Background: Chronic subdural hematoma (cSDH) is a common neurosurgical pathology causing significant morbidity and mortality, yet optimal management and intervention remains controversial.
Methods: We describe embolization of the middle meningeal artery (MMA) and placement of subdural evacuating port systems (SEPS) by a dual trained open and endovascular neurosurgeon. Both procedures are done in sequence in the interventional radiology suite, and real time radiographic results are demonstrable with Xper-CT.
Conclusions: MMA Embolization followed by evacuation of cSDH with a SEPS is a valuable strategy to mitigate perioperative risk factors and patient comorbidities, through a minimally invasive evacuation with subsequent embolization minimizing recurrence.
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