Neurointerventional procedures began with the mating of small balloons with small catheters to take advantage of blood flow to reach and treat high-flow lesions. The field grew with the development of microcatheters that were carried by flow to their destination. The flow of the fistula or arteriovenous malformation could then be obstructed. These advances led to explosive growth after the development of microguidewires and microcatheters. The interventionalist was no longer restricted to treating high-flow lesions but could access normal-flow or even reduced-flow lesions. Aneurysms could be filled with balloons, coils, or permanent liquids. Flow could be rearranged by deposition of platinum microcoils. With angioplasty or thrombolysis, reduced or absent flow could be restored to normal. Medications could now be delivered in the desired vessel distribution to treat tumors or vasospasm or to test the function of the territory supplied by the injected vessel. New embolic agents and innovative uses of existing agents have expanded the treatment options for numerous disorders. Physician and patient enthusiasm for these techniques and materials has spurred extensive commercial interest and innovation. The coming years will see the introduction of many more new devices and agents for the treatment of difficult intracranial processes. The only restraints will be the physical limitations of the materials and drugs developed to treat central nervous system disorders.
- Guide catheters
- Interventional materials