Severe migraine affects over 4 million Americans — 8 or more headache days per month that disrupt work, relationships, and daily life. Nearly half of patients do not achieve adequate relief from CGRP inhibitors, Botox, or other preventives. If you have tried multiple medications and still live with disabling migraines, TEMMA may be an option.
Targeted Embolization for Migraine Management. TEMMA is a minimally invasive endovascular procedure that uses a tiny platinum coil to reduce blood flow through the middle meningeal artery (MMA) — the vessel that supplies the dura, the brain's pain-sensitive outer lining.
In migraine, the MMA dilates and the dura becomes inflamed, triggering the pain cascade that medications try — and often fail — to control. By reducing blood flow to this pathway, TEMMA directly addresses the source of migraine pain.
Not a candidate if migraines are well-controlled on current medication.
No other migraine procedure offers a predictive test. Before any permanent decision, we deliver a small amount of lidocaine to the MMA. We then check your migraine pain over the next 90 minutes.
Light sedation. A thin catheter is guided through a small puncture in the groin or wrist to the MMA. Lidocaine is infused, and we monitor your headache response for 90 minutes. If positive → schedule embolization for a separate visit.
Light sedation. The same catheter approach. A tiny platinum coil is placed in the MMA to reduce blood flow to the dura. The procedure takes 30–40 minutes. Closure device at the puncture site. Same-day discharge.
We follow up with you over the next 12 months to track your progress.
The diagnostic angiogram and lidocaine test are typically covered; the embolization for migraine is not yet universally covered. Our team will work with you to verify your benefits and explain your options before any procedure.
*Among lidocaine-test-positive patients proceeding to bilateral coil embolization. Individual results vary.