Neurointervention in the 2020s: Where are We Going?
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Neurointervention in the 2020s: Where are We Going? Mayank Goyal1,2
· Wim van Zwam3 · Jacques Moret4 · Johanna Maria Ospel1,5
Received: 23 June 2020 / Accepted: 8 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
A Brief Summary of the History of Neurointervention The 1970s and 1980s—Discovery The history of neurointervention is short as our field is still in its puberty. If one had to pinpoint a starting date, most would agree it was the early 1970s, although Luessenhop and Spence described a case of an endovascular embolization of a brain arteriovenous malformation as early as 1960 [1]. The 1970s was the time when the pioneers of the field boldly went where no one had gone before. Their brilliant minds made huge advancements in the understanding of complex vessel anatomy and neurovascular pathology, and we have to particularly recognize the tremendous input of Pierre Lasjaunias in the delicate and precise description of the vascular microanatomy of the base of the skull, and Fedor Serbinenko, who developed a technique to treat intracranial aneurysms and carotid cavernous sinus fistulas with a detachable latex balloon [2]. In the 1980s, Zeumer and Theron entered the field of endovascular stroke treatment and opened intracranial occlusions with locally administered fibrinolytics [3, 4]. Only a few conditions were treatable but the sudden knowledge gain was massive and Mayank Goyal
[email protected] 1
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
2
Department of Radiology, University of Calgary, Calgary, Canada
3
Department of Radiology and Nuclear Medicine, Cardiovascular Research Institute Maastricht, School for Mental Health and Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
4
5
The Brain Vascular Center, Baujon University Hospital, Paris, France Division of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
led to an aura of intrigue and excitement that attracted numerous talented young clinician researchers to the field. This led to the foundation of the first companies that were dedicated to manufacturing devices for endovascular minimally invasive procedures.
The 1990s—Innovation In the early 1990s one of the most groundbreaking inventions in our specialty was made: the Guglielmi detachable coil was used for the first time in a patient with a carotid artery aneurysm in 1990 [5] and by the end of the 1990s endovascular coiling became a well-established treatment option for both ruptured and unruptured aneurysms [6]. Procedural innovation paralleled engineering innovations, and leaders in the field started treating seemingly impossible aneurysms with various neck-bridging techniques [7]. Neurointerventionalists at that time also experimented with existing technologies in other conditions, such as brain arteriovenous malformations (AVM), carotid stenosis and acute stroke, but were unable to make massive inroads. It was in the
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