Overview of new progresses in neurointervention: promise and problems / 中华外科杂志

ABSTRACT

In recent two years, new reports about concepts, technologies, materials, and especially new clinical trial results for endovascular treatment of cerebrovascular diseases, has provided tremendous promise for further progress. Mechanical thrombectomy becomes a guideline-recommended therapy for acute ischemic stroke patients with large vessel occlusion, which is considered as a landmark event. The superiority of endovascular coiling over neurosurgical clipping has been further proved for intracranial aneurysm. New devices are constantly developing for aneurysm occlusion. For brain arteriovenous malformation, application of detachable-tip microcatheters improves safety of embolization procedure, and successful transvenous embolization has been also achieved in a few cases. Long-term result of carotid stenting for symptomatic patients has been proved to be noninferior to carotid endarterectomy. Meanwhile, some new trials only obtain negative results, for example, endovascular stenting for intracranial or vertebral artery stenosis both show worse outcomes compared with medical therapy alone. More advancements and investigations are needed.