Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series.
H, S., Y, Q., J, H., T, G., M, S., X, Q., J, C., Y, D., X, J., & S, D. (2026). Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1896356
H S, Y Q, J H, T G, M S, X Q, et al. Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series.. Frontiers in neurology. 2026; doi: 10.3389/fneur.2026.1896356
H S, Y Q, J H, et al. Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series.[J]. Frontiers in neurology. 2026. DOI: 10.3389/fneur.2026.1896356.
@article{h2026,
author = {Shen H and Qian Y and Hu J and Gao T and Sheng M and Qian X and Chen J and Ding Y and Jiang X and Dong S},
title = {Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series.},
journal = {Frontiers in neurology},
year = {2026},
doi = {10.3389/fneur.2026.1896356},
note = {PMID: 42656445},
}
TY - JOUR AU - Shen H AU - Qian Y AU - Hu J AU - Gao T AU - Sheng M AU - Qian X AU - Chen J AU - Ding Y AU - Jiang X AU - Dong S TI - Adjunctive middle meningeal artery embolization with low-viscosity liquid embolic agents for acute epidural hematoma: technical considerations and a case series. T2 - Frontiers in neurology PY - 2026 DO - 10.3389/fneur.2026.1896356 AN - PMID:42656445 ER -
OBJECTIVE: To assess the feasibility, safety, and short-term outcomes of adjunctive middle meningeal artery (MMA) embolization using low-viscosity liquid embolic agents (1:1 diluted Onyx/DMSO and 1:9 diluted Glubran 2/Ethiodized Poppyseed Oil Injection) for acute epidural hematoma (AEDH). METHODS: We retrospectively reviewed 9 consecutive AEDH patients evaluated for MMA embolization at our institution. Eight underwent embolization, and one was converted to immediate craniotomy after pre-procedural cranial CT showed rapid hematoma expansion. In the embolization subgroup, low-viscosity agents included 1:1 diluted Onyx with dimethyl sulfoxide (DMSO) (n = 6) and 1:9 diluted Glubran 2/ethiodized oil (n = 2). Primary observations included technical success, radiographic evolution, clinical outcomes, and periprocedural complications. RESULTS: Technical success was achieved in all embolized cases (8/8). Across the eight embolized cases, low-viscosity agents reached distal dural branches without relevant proximal reflux, and no catheter adherence or catheter entrapment was observed. No procedure-related complications occurred. Follow-up imaging showed stable or resolving hematomas in all embolized patients, and none required rescue surgery for post-embolization expansion. Median discharge GCS was 15, and no new neurologic deficits were observed. In the non-embolized conversion case, immediate pre-procedural CT showed interval progression, and prompt craniotomy was performed. CONCLUSION: In selected AEDH patients, adjunctive MMA embolization with low-viscosity liquid embolic agents (1:1 diluted Onyx/DMSO and 1:9 diluted Glubran 2/ethiodized oil) was technically feasible with a favorable short-term safety profile and may help control bleeding and reduce the risk of hematoma expansion while balancing distal penetration and catheter control. This strategy may provide a minimally invasive treatment option for high-risk AEDH, but multicenter studies with larger retrospective case series are needed for confirmation.