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CUTTING EDGE NEUROSURGERY
Gupta V. 1, Gandhi C. D. 2, Prestigiacomo C. J. 3
1 Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA;
2 Endovascular Neurosurgery Fellowship Program, Neurosurgery TBI Research, Neurological Institute of New Jersey, New Jersey Medical School, Newark, NJ, USA;
3 Department of Neurological Surgery, Departments of Radiology and Neurology and Neurosciences, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
Rapid technological advances in the endovascular field has revolutionized the treatment of intracranial aneurysms. Since the Food and Drug Administration approval of Guglielmi detachable coils in 1995, a variety of newer coils with different design and physical properties such as complex coils, stretch resistant and bioactive coils, have become available promising to increase packing density and decrease aneurysmal recurrence and recanalization rates. Treatment of wide neck intracranial aneurysms has improved with availability of compliant balloons and newer intracranial assist devices. Emerging technology such as flow diverters hold promise in treatment of large and difficult to treat intracranial aneurysms. Liquid embolic agent (Onyx HD 500) offer a novel, safe and effective adjunctive treatment option when used in combination with coils with stent and/or balloon assist technique. Endovascular treatment options have vastly expanded the armamentarium of neurosurgeons allowing safe and durable treatment of aneurysms previously amenable to clipping only.