Development of medical devices for neuro-interventional procedures: special focus on aneurysm treatment.
Since the introduction of the Guglielmi detachable coil in 1990, the role of endovascular treatment for intracranial aneurysm has changed significantly. However, this endovascular modality has intrinsic technical limitations in wide-neck and large (11-25 mm) or giant (>25 mm) aneurysms. Long-term anatomic outcomes for these aneurysms include an approximate 25% recanalization rate. Since the aneurysm recanalization is related to morphologic, hemodynamic and biologic factors associated with aneurysm healing, improvement of these factors has elicited several technical modifications of the original technique. This review will describe new endovascular devices that have been manufactured to improve the technical limitations inherited by the Guglielmi detachable coil technique, as well as the historic background of endovascular treatment for cerebral aneurysms.
Yuki
Ichiro
I
Department of Radiological Sciences, Division of Interventional Neuroradiology, University of California Los Angeles School of Medicine, USA. iyuki@mednet.ucla.edu
Murayama
Yuichi
Y
Vinuela
Fernando
F
D001807:Blood Vessel Prosthesis; D004867:Equipment Design; D019544:Equipment Failure Analysis; D004864:Equipment and Supplies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods