EMMA-CAN
(2025)Objective
To evaluate middle meningeal artery embolization (EMMA) as an adjunct to surgery for reducing recurrence of chronic subdural hematoma
Study Summary
• EMMA + surgery reduced radiographic recurrence >3-fold vs surgery alone (6.5% vs 22.8%)
• Symptomatic recurrence reduced ~6-fold (2.2% vs 14.8%)
• Safety comparable with no procedure-related adverse events
• Symptomatic recurrence reduced ~6-fold (2.2% vs 14.8%)
• Safety comparable with no procedure-related adverse events
Intervention
Surgery + EMMA (within 72h, using Onyx-18 liquid embolic) vs Surgery alone
Inclusion Criteria
Unilateral chronic subdural hematoma
Study Design
Arms: Surgery + EMMA vs Surgery alone (standard care)
Patients per Arm: 192 total across 8 Canadian centers (arm breakdown not specified)
Outcome
• Primary: Radiographic recurrence at 90 days: 6.5% vs 22.8%
• Symptomatic recurrence: 2.2% vs 14.8%
• SAEs: 7.6% vs 8.1% (comparable)
• 90-day mortality: 2.2% vs 2.3% (comparable)
• Symptomatic recurrence: 2.2% vs 14.8%
• SAEs: 7.6% vs 8.1% (comparable)
• 90-day mortality: 2.2% vs 2.3% (comparable)