Artificial intelligence-assisted middle meningeal artery embolization for chronic subdural hematoma with overlay visualization

The effectiveness of middle meningeal artery (MMA) embolization for chronic subdural hematoma is well established,1-3 and distal and multibranch penetration of embolic agents is recognized as a key factor for better outcomes.4 5 In recent years, several studies have described artificial intelligence (AI)-assisted neuroendovascular treatment.6-9 We recently reported that AI-assisted MMA embolization may enhance procedural safety through reflux detection and notification.10 This case (video 1) focuses on the overlay feature, highlighting its potential to improve procedural efficacy by enabling greater distal and multibranch penetration, resulting in a larger embolization volume. The overlay feature provided by the AI system enhanced visualization and notifications, enabling not only improved safety but also more effective multibranch penetration. As MMA embolization becomes more widespread, especially among younger operators, AI support that combines safety with efficacy holds promise for both clinical practice and training. Larger studies are needed to validate these findings further. neurintsurg;18/3/894/V1F1V1Video 1Artificial intelligence-assisted middle meningeal artery embolization with overlay visualization promoting distal and multibranch penetration.