Page 59 - Inaugural Lecture Prof Dr Ahmad Sobri Muda

Ahmad Sobri Muda

INNOVATIONS AND FUTURE TRENDS

The work of two Italian physicians, Cesare Gianturco and Guido
Guglielmi, between the late 1980s and the beginning of the nineties,
significantly transformed neurointervention. Gianturco’s coils,
which he used to embolize abnormal blood vessels and aneurysms,
created from combined deep understanding of radiology with
capability to solve technical and conceptual problems. Gianturco
also patented the very first endovascular stent endorsed by the
American Food and Drug Administration. While Sadek Hilal was
the pioneer to use coils to treat brain aneurysms in the mid-1980s,
however his method was unreliable and risky because the coils were
delivered without much control which can obliterate the parent
artery harbouring the aneurysm. Guido Guglielmi’s work at UCLA
completely changed neurovascular coil technology, by employing
small electricity current as a controlled release mechanism for
coils. He and his team, published two works in 1990, describing
the embolization techniques of brain aneurysms using detachable
platinum coils. Thereby, makes endovascular treatment of brain
aneurysm became more accessible and safer.
Since the 2000s, intracranial stents have been used to prevent
coils deployed inside the sac from bulging into the parent artery
during endovascular treatment of brain aneurysms. In many
cases, neurointerventional procedure using flow diverter stents
entails inserting the FD stent into the parent vessel harbouring
the aneurysm alone without putting any coils. The advancement
of neurointerventional tools, medical imaging technologies,
and devices, reinforced by ISAT randomised trials, making the
endovascular as the mainstay of treatment for brain aneurysm.
Subsequently, flow diversion devices were created to reconstruct
the vessel’s anatomy and influence the flow, without immediately
closing the aneurysm, preserving side branches.

49 ❘❘❚