Newer endovascular tools: A review of experimental and clinical aspects

Thomas Sorenson, Waleed Brinjikji, Giuseppe Lanzino

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

The history of treatment of intracranial aneurysms dates backto the late 18th century. These early physicians largely based their crude techniques around "wire insertion alone, galvanopuncture (electrothrombosis), and fili-galvanopuncture (wire insertion together with electrothrombosis)," albeit with overwhelmingly unfavorable outcomes. By the end of the 20th century, treatment options progressed to include two highly effective, and safe, procedures: surgical clipping and endovascular coiling. These methods have been found to be effective treatments for a large portion of aneurysms, but there still exists a subset of patients that do not respond well to these therapies. While much progress has been made in stent-assisted coiling including the development of newer stents aimed at keep the coil ball from protruding into the parent vessel, the introduction of flow diverters has characterized a new phase in the endovascular treatment of intracranial aneurysms. This treatment paradigm is rapidly becoming the treatment of choice for large and complex aneurysms internal carotid artery. Intrasaccular flow diverters such as the Woven EndoBridge device (WEB) and Luna device are showing promise in the treatment of wide neck bifurcation aneurysms. Other newer devices including the pCONus Bifurcating Aneurysm Implant and Endovascular Clip Systems (eCLIPs) are showing promise in small clinical and preclinical studies. As technology improves, newer devices with ingenious designs are constantly being introduced into the clinical arena. Most of these devices try to address the limitations of traditional endovascular methods in regard to providing a safe and effective treatment of wide-necked bifurcation aneurysms. Several large prospective studies are underway and once completed, the role of these newer devices will be better defined. It is easy to anticipate that with advances in 3D techniques and printing, a future in which customized devices are designed based on the individual anatomy and morphology of the aneurysm in a given patient is within reach.

Original languageEnglish (US)
Pages (from-to)116-125
Number of pages10
JournalJournal of Neurosurgical Sciences
Volume60
Issue number1
StatePublished - Mar 1 2016

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Aneurysm
Equipment and Supplies
Therapeutics
Intracranial Aneurysm
Stents
Internal Carotid Artery
Surgical Instruments
Anatomy
Neck
History
Prospective Studies
Technology
Physicians

Keywords

  • Aneurysm
  • Endovascular procedures
  • Intracranial aneurysm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Newer endovascular tools : A review of experimental and clinical aspects. / Sorenson, Thomas; Brinjikji, Waleed; Lanzino, Giuseppe.

In: Journal of Neurosurgical Sciences, Vol. 60, No. 1, 01.03.2016, p. 116-125.

Research output: Contribution to journalReview article

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