Middle Meningeal Artery Embolization for Chronic SDH Post-Carotid Stenting | IRFACILITIES


A patient with a history of chronic subdural hematoma (SDH) underwent carotid artery stenting, necessitating the initiation of dual antiplatelet therapy. Following this intervention, the patient developed an acute SDH, a known complication when antiplatelets are introduced in patients with pre-existing subdural collections. Given the risk of worsening hematoma due to antiplatelet therapy, a middle meningeal artery (MMA) embolization was performed. This minimally invasive procedure, which targets the vessels supplying the subdural space, was chosen to stabilize the chronic SDH and reduce the risk of further hemorrhage without discontinuing the necessary antiplatelet therapy. MMA embolization proved successful in managing the chronic SDH, mitigating the need for more invasive surgical interventions such as craniotomy, and allowing the patient to safely continue antiplatelet therapy for the recently placed carotid stent. The patient’s clinical course was favorable, with no further episodes of acute bleeding and gradual resolution of the SDH.

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