Superficial temporal artery retrograde access for the treatment of chronic subdural hematomas.

Publication Title

Neurosurgical focus [electronic resource]

Authors

Akshal Patel, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.Follow
Yince Loh, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.Follow
Luke L Jouppi, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.Follow
Radwan Takroni, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.
Daniel C Norvell
Stepan Capek
Nicolas M Caffes
Majid Aljoghaiman, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.
Aaron J Gustin, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.
Aws A Alawi, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.
Zane Tymchak, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.Follow
Cameron G McDougall, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.Follow
Stephen Monteith, Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington.Follow

Document Type

Article

Publication Date

10-1-2025

Keywords

Humans; Hematoma, Subdural, Chronic; Male; Female; Aged; Retrospective Studies; Temporal Arteries; Middle Aged; Embolization, Therapeutic; Treatment Outcome; Aged, 80 and over; Femoral Artery; Radial Artery; endovascular; middle meningeal artery embolization; minimally invasive; novel; subdural hematoma; superficial temporal artery; washington; swedish; swedish neurosci

Abstract

OBJECTIVE: Middle meningeal artery (MMA) embolization for chronic subdural hematoma (cSDH) has ushered in a treatment paradigm shift. The objective of this study was to determine whether the superficial temporal artery (STA) could be used consistently and just as effectively compared to conventional femoral and radial artery access.

METHODS: The authors retrospectively reviewed a series of consecutive cases from January 1, 2024, to February 28, 2025, where the STA was used to treat cSDH. The 90-day readmission, retreatment, and death rates were collected and compared against a set of internal comparison cases that underwent similar treatment, though via femoral or radial artery puncture.

RESULTS: The study included 40 patients with STA retrograde (STAR) access and 50 patients who had traditional transfemoral or radial artery approaches. In the STA group, there was significantly reduced radiation exposure (p < 0.001) and less contrast administration (p < 0.001). There were no differences between the groups in terms of the 90-day readmission (p = 0.82), retreatment (p = 0.93), or death rates (p = 0.42). One access site complication was observed after a transfemoral intervention.

CONCLUSIONS: STAR access is an alternative for MMA embolization in cSDH. This innovative approach can potentially rival the results achieved by traditional techniques.

Area of Special Interest

Neurosciences (Brain & Spine)

Specialty/Research Institute

Neurosciences

DOI

10.3171/2025.7.FOCUS25539