(1730) Evaluation of Middle Meningeal Artery Embolization Outcomes at a Level One Trauma Center

Introduction: Subdural hematomas (SDH) are a common form of traumatic brain injury that can present as both acute or chronic. It is estimated that 10-20% of all head trauma admissions in the United States are related to SDH’s, affecting ~ 58 per 100,000 individuals. Understanding how to manage subdural hematomas in the aging population is critical as it is suspected that the incidence of SDHs will increase by 53% over the next 20 years. Management can be broken down to conservative, with focus on medical optimization; or interventional, which often involves a drainage procedure.

Middle Meningeal artery embolization (MMAE) is a minimally invasive procedure which limits the blood supply to the dura and promotes reabsorption of hematoma. While the procedure was originally approved for chronic SDH management, it is now being used in the acute setting, despite very limited data assessing its safety or impact on patient outcomes.

It is hypothesized that patients who receive MMA embolization during the initial hospitalization have a lower rate of SDH recurrence or need for additional unplanned surgery.

Methods: A retrospective review was completed of patients presenting with SDH and undergoing MMAE either during index hospitalization or on a semi-elective basis at a single tertiary care, level one trauma center between February of 2020 and March 2023. A secure database was created to house patient data. Two-sided t-tests were utilized to compare the readmitted group to the non-readmitted group.

Results: A total of 130 trauma patients were included in the database. 78.6% of patients were >/= to 65 y/o, 68.7% of patients were male, 31.3% of patients were female. In our population, statistical analysis shows that patients who undergo MMAE earlier were more likely to have a shorter LOS and that patients who had a smaller SDH prior to MMA were less likely to be readmitted (p value 0.028).

Conclusions: Understanding the optimal timing for an MMAE in the acute setting is an evolving area of research. This is one of the largest known reviews of patients who have undergone MMAE at a single institution. Our data suggests that patients who undergo MMAE earlier in their hospital stay are more likely to have shorter LOS.