Endovascular Management of Subdural Hematoma with Middle Meningeal Artery Embolization Utilizing Standalone Coils: A Single Center Experience

Authors

• Macy Mitchell, Michigan State University College of Human Medicine Medical Student
• Sarosh Madhani, Neurology Resident - Corewell Health West
• Michael Morrison, Michigan State University College of Human Medicine Medical Student
• Andrew DeGroot, Neurosurgery Resident - Corewell Health West
• Jeffery Farooq, Neurosurgery Resident - Corewell Health West
• Mohamed Somji, Neurosurgery - Corewell Health West
• Paul Mazaris, Neurosurgery - Corewell Health West

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Middle meningeal artery embolization (MMAe) has emerged as an effective adjunct or alternative to surgery for chronic subdural hematoma (cSDH). While particles and liquid embolic agents are commonly used, data on standalone coil embolization remains limited. We aim to evaluate the safety and efficacy of standalone coil embolization of the middle meningeal artery for the treatment of subdural hematoma in the largest single-center series to date.

We retrospectively reviewed patients who underwent MMA embolization with standalone coils between July 2023 and June 2025. Demographics, procedural characteristics, complications, and radiographic outcomes were collected. Imaging outcomes were assessed at 1-4 weeks, 6-12 weeks, and 4-6 months post-procedure. Primary efficacy outcome was unplanned repeat surgical drainage; primary safety outcome was major procedural complications.

77 patients underwent 101 standalone coil embolizations. Mean age was 71.3 years, and 76.6% were male. Bilateral embolization was performed in 31.2% of cases, and 77.9% of procedures utilized radial access. Technical success was achieved in 100% of cases. Radiographic improvement or resolution was observed in 46.6% at 1-4 weeks, 69.3% at 6-12 weeks, and 95.1% at 4-6 months. Four hematomas recurred, with only two requiring repeat surgical drainage. No major procedural complications occurred. Distal coil penetration was associated with higher rates of near-complete or complete resolution, though this was not statistically significant.

Standalone MMA coil embolization is a safe and effective treatment for subdural hematoma, demonstrating high technical success, low retreatment rates, and favorable radiographic outcomes. These findings support coils as a viable standalone embolic option.

Recommended Citation

Mitchell M, Madhani S, Morrison M, DeGroot A, Farooq J, Somji M, Mazaris P. Endovascular management of subdural hematoma with middle meningeal artery embolization utilizing standalone coils: A single center experience. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2024