Endovascular Treatment of Intracranial Arterial Aneurysms: A Neuroradiologist’s Viewpoint

Abstract

It is difficut to be the judge of one’s own situation, which is precisely why this analysis made by a neuroradiologist cannot avoid some degree of a partisan spirit and moreover a degree of partiality, even though it has been edited with the author’s intention of avoiding any bias. For the first time since the existence of interventional neuroradiology, one of its most recent therapeutic applications is being considered as a potential replacement for a surgical procedure if only partially but to a degree that is difficult to predict. I refer specifically to the clipping of an intracranial arterial aneurysm. Neuroradiologists who treat the same aneurysm by the endovascular route believe their efforts to be important and glorify them as much as possible. It is possible to comprehend this attitude if the quality of the results is comparable. Alternatively, if neurosurgical treatment is at peak quality with minimal fallibility, it would similarly be glorified as the best approach for intracranial aneurysms. Only by strict scientific honesty will one or the other approaches prevail. It would be detrimental to patients and to the scientific community if the truth of the results were altered in even the slightest degree under the cover of an ill-conceived defense of doing business for business’ sake. The primary assumption is therefore to ensure that a competition not take place between interventional neuroradiologists and neurosurgeons but between two therapeutic techniques, thereby providing greater benefit to the patient.