WSC 2025 | Key challenges to implementing EMMA for the treatment of chronic subdural hematoma
Jai Shankar, MD, DM, MSc, FRCPC, University of Manitoba, Winnipeg, Canada, highlights the key challenges to implementing embolization of middle meningeal artery (EMMA) for the treatment of chronic subdural hematoma. He mentions that the biggest challenge isn’t whether EMMA works, but ensuring that all patients have access to it. This interview took place at the 17th World Stroke Congress (WSC) in Barcelona, Spain.
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Transcript
The main challenge to implementing EMMA in routine practice are ensuring broad access to endovascular expertise, establishing standardized patient selection and procedural protocols and addressing cost and reimbursement issues. Many hospitals treating chronic subdural hematoma don’t yet have neurointerventional services. So training infrastructural collaboration between neurosurgery and interventional neuroradiology teams will be crucial to safely and consistently integrate EMMA into care pathways...
The main challenge to implementing EMMA in routine practice are ensuring broad access to endovascular expertise, establishing standardized patient selection and procedural protocols and addressing cost and reimbursement issues. Many hospitals treating chronic subdural hematoma don’t yet have neurointerventional services. So training infrastructural collaboration between neurosurgery and interventional neuroradiology teams will be crucial to safely and consistently integrate EMMA into care pathways. So in summary, what I would say is the biggest challenge isn’t whether EMMA works. The bigger challenge is how to make it available and consistent. That means building endovascular capacity, standardizing protocols and ensuring reimbursement so that every patient who could benefit actually gets access to it.
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Disclosures
Research grant for EMMA-Can study from Medtronic.
