Page 62 - Inaugural Lecture Prof Dr Ahmad Sobri Muda

Neurointervention

the embolic material into the brain AVM nidus. This helps the
neurointerventionist to maximize filling of the nidus to achieve
total occlusion. Following the success of ONYX, a few other
copolymers like SQUID and PHIL were developed and approved
for use. With new embolic materials, many centers managed to
achieve a higher percentage of occlusion of the brain AVM nidus,
which assisted significantly in surgical resection. In many cases,
total nidus occlusion is possible, especially in lower grade brain
AVM.
Dural AVM also benefits tremendously from the advancement
of liquid embolic material. The new liquid embolic material
is extremely effective because it can cross the fistula point in
dural AVM and penetrate deeply beyond the dura. Due to this
development, surgical ligation of dural AVMs is now essentially
unheard of and endovascular treatment of dural AVMs has taken
over as the standard of care.
Basic neurointerventional tools like access catheters, sheaths,
support catheters and various wires are also undergoing fast
innovation. There are various choices of support catheters and
microcatheters designed specifically for various neurointerventional
procedures. Some of the microwires and catheters were developed
to become smart devices that can collect data. This aids
neurointerventionalists in their understanding of the lesion, for
instance, the makeup of the clot when performing thrombectomy.
With the data and understanding of the type of clot and the content,
a better device or technique can be adopted to achieve better results.
Data is becoming more crucial and important in order to help
with treatment choices, patient selection, and improving outcomes.
Neurointervention will need to embrace the trend of data analytics,
machine learning, and AI employing neuroimaging data in order

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