UC San Diego Health is the first health system on the West Coast to use a new coil technology for the treatment of chronic subdural hematoma, or chronic brain bleeds, and among the early adopters of a newly FDA-approved liquid-based treatment that helps block blood vessels linked to the same condition. Together, these advances expand minimally invasive treatment options for one of the fastest-growing neurosurgical disorders affecting older adults.
This novel procedure was led by David Santiago-Dieppa, MD, cerebrovascular and endovascular neurosurgeon at UC San Diego Health and associate professor of neurological surgery at the University of California San Diego School of Medicine.
"Chronic subdural hematoma is an increasingly common condition in neurosurgery and patients benefit from minimally invasive approaches that can reduce the need for repeat operations," said Santiago-Dieppa. "The patient at UC San Diego Health treated with this new coil technology is recovering well, which is encouraging as we continue to evaluate its potential. At the same time, advances in both coil-based and liquid embolization technologies are giving physicians more options to tailor treatment to each patient's anatomy and clinical needs. Our hope is that these innovations will help us more consistently treat the source of these brain bleeds and improve outcomes for patients."
Chronic brain bleed occurs when blood collects between the brain and its outer covering, often after a minor head injury. The condition is becoming more common as the population ages and more people take blood-thinning medications. Experts project it could become the most common cranial neurosurgical conditions in adults by 2030.
In recent years, a minimally invasive procedure called middle meningeal artery (MMA) embolization has improved treatment for many patients with chronic subdural hematoma. Rather than requiring surgery alone, physicians can navigate a tiny tube through blood vessels to block the artery associated with the bleed, helping prevent it from coming back. Studies have shown that MMA embolization can reduce the likelihood that patients will need additional procedures and may improve long-term outcomes.
As MMA embolization has gained widespread adoption, new technologies have emerged to improve how physicians close the artery associated with the bleed. Some approaches use specialized coils to mechanically block blood flow, while others use liquid embolic materials designed to reach smaller vessel branches farther from the treatment site. The newly introduced coil technology is designed to help physicians shut down the artery more completely and efficiently. Its flexible design allows it to be delivered through small blood vessels and treat a longer section of the artery than previous embolization coils.
Together, these advances provide physicians with more options to customize treatment based on a patient's anatomy and clinical needs. With his extensive experience performing MMA embolization procedures, Santiago-Dieppa provided clinical insights during the device's development, helping shape a technology intended to improve procedural efficiency and artery closure.
UC San Diego Health has played a leading role in advancing MMA embolization techniques. Researchers in the Department of Neurological Surgery at UC San Diego School of Medicine developed the Patency After Coil Embolization (PACE) scoring system, which measures how completely blood flow through the artery has been eliminated after treatment. Early research suggests that more complete closure of the artery may be linked to better resolution of the brain bleed over time.
UC San Diego Health was also among the early adopters of liquid embolic agents for MMA embolization following evidence from national clinical trials supporting their use in chronic subdural hematoma. J. Scott Pannell, MD, director of neurointerventional surgery, endovascular neurosurgeon and neurointerventional radiologist at UC San Diego Health and professor of neurological surgery and radiology at UC San Diego School of Medicine, served as a site investigator for the EMBOLISE clinical trial, which evaluated the addition of MMA embolization to standard treatment. His involvement helped bring new embolization techniques and clinical research opportunities to patients at UC San Diego Health.
"The growing body of evidence supporting MMA embolization has fundamentally changed how we approach chronic subdural hematoma," said Pannell. "Liquid embolic technologies offer a primary option that may allow physicians to achieve more complete treatment in select patients. Participating in clinical trials, such as EMBOLISE has been critical to understanding how these therapies can improve patient outcomes."
The early use of these technologies and contributions to the scientific literature highlights UC San Diego Health's leadership in developing and evaluating new treatments for patients with complex neurological conditions.
As physicians continue to refine MMA embolization, technologies such as these may help make treatment more predictable, effective and accessible for the growing number of patients diagnosed with chronic subdural hematoma each year.
UC San Diego Health is nationally recognized for excellence in the treatment of complex brain, spine and cerebrovascular disorders. With leading experts in minimally invasive neurosurgery, the program is advancing the future of neurological care through innovative research, clinical trials and groundbreaking technologies. Patients benefit from comprehensive, multidisciplinary care for conditions including stroke, aneurysms, brain tumors, spinal disorders and traumatic brain injury. In the 2026-2027 I Best Hospitals rankings, UC San Diego Health's neurology and neurosurgery program was ranked among the nation's best.
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