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(Stroke. 2009;40:e305.)
© 2009 American Heart Association, Inc.

Advances in Stroke 2008

Advances in Interventional Neuroradiology

Ajay K. Wakhloo, MD, PhD; Michael J. Deleo, III, MD Martin M. Brown, MD, FRCP

From Department of Radiology (A.K.W., M.J.D.), University of Massachusetts, Worcester, Mass; Institute of Neurology (M.M.B.), National Hospital, London, UK.

Correspondence to Ajay K. Wakhloo, MD, PhD, Professor of Radiology, Neurology and Neurosurgery, Director, Division Neuroimaging and Intervention (NII), Department of Radiology, University of Massachusetts, 55 Lake Avenue North, Worcester, MA 01655.

In 2008 we witnessed a rapid advancement in stent technology, which is reflected in the high number of case reports, publications of case series, and randomized trials. Stents not only served for a combined intrasaccular and extrasaccular treatment of challenging aneurysms but also assisted the revascularization in acute and chronic ischemic conditions of the neurovascular system. Although a self-expanding nitinol semiopen cell stent is currently used for intracranial occlusive disease, a new retrievable closed-cell designed stent is widely used for aneurysms because of its easy delivery through a microcatheter in frequently tortuous head and neck as well as cerebrovascular circulation (Figure 1). However, despite numerous publications in the field, the widespread acceptance of the use of stents to routinely treat carotid stenosis awaits the results of the multicenter randomized clinical trials that should be available in 2009. The role of interventional neuroradiology in the treatment of acute ischemic stroke continues to expand and excite interest.

View larger version (104K): [in this window] [in a new window]   Figure 1. Intracranial nitinol self-expanding stents used for endovascular treatment of aneurysm in conjunction with coil embolization. A, Closed cell design with flaring ends (Enterprise VRD; Codman Neurovascular, Raynham, MA). B, Semiopen cell design (Neuroform; Boston Scientific, Natick, MA).

Key Words: interventional neuroradiology • intracranial aneurysm • stroke management • carotid stenting • intracranial stenting