Transradial approach for middle meningeal artery embolization is a safe alternative to transfemoral approach in patients with chronic subdural hematoma: A single-center retrospective comparative study

• Published in: Clinical neurology and neurosurgery 2024-11, Vol.246, p.108525, Article 108525
• Main Authors: Hung, Alice, Ran, Kathleen, Das, Oishika, Ejimogu, Emeka, Yang, Wuyang, Caplan, Justin, Gonzalez, Fernando, Xu, Risheng
• Format: Article
• Language: English
• Subjects: Alcohol use; Blood; Brain; Cardiovascular disease; Carotid arteries; Chronic subdural hematoma; Dura mater; Embolization; Hematoma; Intensive care; Length of stay; Meninges; Middle meningeal artery embolization; Patient satisfaction; Patients; Transfemoral; Transradial
• ISSN: 0303-8467; 1872-6968; 1872-6968
• DOI: 10.1016/j.clineuro.2024.108525

Transradial approach (TRA) has been increasingly utilized in various neuroendovascular interventions as a safe alternative to the transfemoral approach (TFA). As middle meningeal artery (MMA) embolization emerges as an effective therapy for treating chronic subdural hematomas (cSDH), some studies have explored using TRA. In this study, we compared procedural times and post-operative outcomes between those with TRA and TFA. This is a single-institution retrospective study of patients undergoing MMA embolization for cSDH. The cohort was divided into the TRA and TFA subgroups. Baseline characteristics, procedural times, and immediate outcomes were compared. Univariate analysis was performed. We performed 62 MMA embolizations for treatment of cSDH, of which 37 (59.7 %) were performed transradial and 25 (40.3 %) were performed transfemoral. Those who underwent TRA were significantly younger than those who had TFA (p = 0.02). For patients who underwent unilateral MMA embolization, those with TRA had significantly shorter duration of procedure compared to the TRF group (p = 0.01). This difference was not observed in the bilateral MMA embolization subgroup. Only three patients had access site complications, and all were in the TFA group. There was no significant difference in length of hospital stay. As MMA embolization for cSDH becomes more prevalent, efforts to optimize the safety and efficacy of the technical aspects become critical. In this study we demonstrate that TRA is a safe and efficient alternative to traditional TFA in those undergoing unilateral MMA embolization. •Middle meningeal artery embolization for chronic subdural hematoma is safe.•There are few procedural-related complications following transradial approach.•Transradial approach reduces procedure and recovery time compared to transfemoral.