No Shinkei Geka. 2026 Jan;54(1):167-177. doi: 10.11477/mf.030126030540010167.
ABSTRACT
Middle meningeal artery embolization (MMAE) has emerged as an important endovascular intervention, though its applications differs between meningiomas and chronic subdural hematomas (CSDH). For meningiomas, MMAE serves as a preoperative adjunct aimed at tumor devascularization and softening to facilitate resection. However, given conflicting evidence regarding its ability to reduce blood loss, careful case selection based on tumor characteristics is essential. Conversely, for CSDH, MMAE targets the inhibition of membrane neovascularization to prevent hematoma recurrence. Recent randomized controlled trials have demonstrated its efficacy as an adjunct to standard treatment, while its role as a standalone treatment continues to show promise. Technical safety relies on a thorough understanding of "dangerous anastomoses" to prevent complications. Furthermore, the transradial approach is highlighted as a viable access route, offering reduced puncture-site complications, particularly for the elderly demographic common to these conditions. This article reviews the current evidence, technical considerations, and future perspectives of MMAE, emphasizing that optimized patient selection is paramount for maximizing therapeutic benefit in both conditions.
PMID:41700049 | DOI:10.11477/mf.030126030540010167