Background Middle meningeal artery (MMA) embolization for subdural hematomas has gained momentum in the neuroendovascular space. However, there is variability in the technique for safe and effective embolization.
Methods This is the first report describing the technical feasibility and performance of using the ZoomTM 45 Aspiration Catheter (Imperative Care, Inc., Campbell, CA) for MMA access to facilitate embolization from February 2021 to March 2023 in a single-center institution.
Results A total of 30 patients were included (mean age: 64.4 ± 26.5 years; male sex: 77.3% [22/30]; Black: 57.1% (16/28). Approximately 36.7% had a history of head trauma (11/30). Fifteen patients (51.7%, 15/29) were either on antiplatelet therapy, anticoagulant therapy, or both. Thrombocytopenia with less than 100,000 platelets per microliter and supratherapeutic international normalized ratio (INR) with INR greater than 2 was seen in 23.3% (7/30) and 13.3% (4/30) of patients, respectively. We used the ZoomTM 45 Aspiration Catheter in all cases of embolization for subdural hematomas with technical success achieved in 100.0% (30/30) of cases, with selective embolization utilizing microcatheter directly into frontal and parietal branches for all patients. Identification of dangerous collaterals, such as lacrimal and petrous branches, prior to embolization, was achieved in all patients (100.0%, 30/30). Bilateral or single MMA embolization was done in 53.3% (16/30) and 46.7% (14/30) of patients, respectively. We used the transradial approach in 53.3% (16/30) of patients, and the transfemoral approach in 46.7% (14/30) of patients. The most common embolization material was n-butyl cyanoacrylate (n-BCA) (90.0%, 27/30), followed by combination of n-BCA and coils (10.0%, 3/30). There were no access site complications or complications related to the MMA embolization procedures and used devices.
Conclusions The use of ZoomTM 45 Aspiration Catheter seems to be technically feasible, safe, and effective for facilitating MMA access for embolization in the context of subdural hematomas.
Disclosures S. Thind: None. R. Morsi: None. J. Carrión-Penagos: None. H. Desai: None. S. Kothari: None. S. Polster: None. J. Siegler: None. E. Coleman: None. S. Mendelson: None. A. Mansour: None. M. Hurley: None. S. Prabhakaran: None. T. Kass-Hout: 2; C; Brainomix: Consultant, Cerenovus: Consultant, Imperative Care: Consultant, Medtronic Inc.: Consultant, Microvention: Consultant, Stryker Neurovascular: Consultant.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.