Transradial middle meningeal artery embolization using Glubran for chronic subdural hematoma: a technical feasibility and safety study

Middle meningeal artery embolization (MMAE) has emerged as a technically feasible treatment strategy for selected patients with chronic subdural hematoma (cSDH). Most reported series utilize transfemoral access and DMSO-based liquid embolics. Data on the feasibility of transradial access (TRA) and the use of Glubran remain limited. We retrospectively reviewed consecutive patients with cSDH who underwent MMAE using Glubran via TRA at a single center between January 2022 and January 2026. Technical success, access-site and procedure-related complications, and radiographic and clinical outcomes were assessed. Embolization was performed using diluted Glubran (8–10%) delivered through selective catheterization of the MMA branches or main trunk. Clinical follow-up and serial CT imaging were obtained. A total of 20 patients underwent 23 transradial MMA embolization procedures, including 3 bilateral cases. Technical success was achieved in all 23 procedures (100%) without conversion to transfemoral access and without access-site complications. No procedure-related neurological complications, ischemic strokes, or intracranial hemorrhages were observed. At follow-up, complete hematoma absorption occurred in 12 of 23 procedures (52%) and partial absorption in 11 of 23 procedures (48%), with no radiographic progression or retreatment. The median follow-up was 3 months (interquartile range 2–6 months), with a mean of 4.6 ± 4.6 months (range 1–23 months). At last clinical follow-up, favorable functional outcome (mRS ≤ 2) was achieved in 18 of 20 patients (90%), with no new neurological deficits. This preliminary study demonstrates the technical feasibility and acceptable short-term safety of transradial MMA embolization using diluted Glubran. Radiographic reduction was observed during short-term follow-up, with no access-site or neurological complications. Larger prospective studies are required to define long-term durability and its clinical role. Not applicable.