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Advanced Technologies in Vascular Neurosurgery
Techniques, Controversies and New Paradigms
ErolVeznedaroglu
123
Advanced Technologies in Vascular Neurosurgery
Erol Veznedaroglu
Editor
Advanced Technologies in Vascular Neurosurgery
Techniques, Controversies andNew Paradigms
Editor
Erol Veznedaroglu Department of Neurosurgery Drexel University School of Medicine Philadelphia, PA, USA
Global Neurosciences Institute
Pennington, NJ, USA
ISBN 978-3-031-67491-4 ISBN 978-3-031-67492-1 (eBook)
https://doi.org/10.1007/978-3-031-67492-1
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2025
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
If disposing of this product, please recycle the paper.
This text is dedicated rst and always to my family, the sacrice of our work rests solely on our families. My wife, Elisabeth, who has supported the crazy life of a Vascular Neurosurgeon for 30 years, and my amazing vchildren, Lauren and Alec, who have been an inspiration and joy.
This year we lost a true Pioneer and Legend—Dr L Nick Hopkins MD. Dr Hopkins saw what none of us did 40 years ago. As all visionaries do, he suffered by challenging the status quo and ghting to show a better way to treat our patients. Dr Hopkins was the rst to open the door of endovascular
therapy as “Brain Surgery” and learn from our partners in Cardiology and Interventional Radiology. This book, and indeed our specialty, would not be possible if it were not for him. Nick was a mentor, friend, and inspiration to all those who were lucky enough to know him. The three “Nick Wisdoms” I remember as a medical student and live by:
Why Not?, If you’re not making waves you’re not doing anything worthwhile, Expletive em

Preface

For the rst time in the history of medicine, technology has out­paced our ability to use it. There is very little that cannot be achieved due to lack of technology; the paradigm shift now is what should we be doing with it. The brain remains the last fron­tier in medicine where we still lack full understanding of its func­tion and vast neural network. This allows for the perfect marriage of technology and discovery for better outcomes and cures of dis­orders of the nervous system. The ability to access virtually every area of the brain via the cerebrovasculature has never been more important.
This ood of new technology, including articial intelligence, brings with it challenges of how best to use it in modern practice. Vascular Neurosurgery has undergone seismic shifts in the last decade. The ability to access the cerebrovascular through a small puncture in the groin or wrist has opened up safe, less-invasive, and better outcomes for previously untreatable conditions. Indeed, endovascular treatment has now become a new option for brain tumors, subdural hematomas, and even intracranial hypertension. The old adage “just because you can do something doesn’t mean you should” has never been more true. The tried and true also has a critical role in this new dawn; however, maintaining basic skills will be more of an issue.
The goal of this text is to expose the new technological advances in a comprehensive and balanced way. As we have learned countless times in modern medicine, new is not always better and in fact may be dangerous. The ability to asses newer
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Preface
techniques in a way that is always in the patients’ best interest is the ultimate goal. In this text, leaders in the eld of Vascular Neu­rosurgery will discuss this new technology as well as the contro­versies it raises. The reader will have an unbiased and comprehensive exposure to the latest innovations and how they are currently being used.
Philadelphia, PA USA ErolVeznedaroglu

Contents

1 The Future of Neurointervention:
New Procedures, New Practitioners,
and New Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Andre Monteiro, William Metcalf- Doetsch, Wasiq I. Khawar, Adnan H. Siddiqui, and Elad I. Levy
2 Minimally Invasive Intracerebral
Hemorrhage Removal . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Jack Jestus, Demi Dawkins, Kenneth Moore, Adam Arthur, and Christopher Nickele
3 Middle Meningeal Artery Embolization
for Chronic Subdural Hematoma . . . . . . . . . . . . . . . . 51
Alina Mohanty and Peter Kan
4 Role of Bypass in the Modern Era:
Technological Advancements in Adjuncts
for EC-IC Bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Sanjana Salwi, Visish Srinivasan, and Jan- Karl Burkhardt
5 Embolic Protection Devices for Carotid Artery
Stenting: Where Is the Evidence? . . . . . . . . . . . . . . . . 71
Mohanad Sulaiman and Mandy J. Binning
6 Closing the Gap: Addressing the Lag
in Stroke Care Evolution . . . . . . . . . . . . . . . . . . . . . . . 87
Erol Veznedaroglu, Karen Greenberg, and Haley Fitzgerald
ix
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Contents
7 Venous Sinus Stenting for Idiopathic
Intracranial Hypertension . . . . . . . . . . . . . . . . . . . . . . 103
Justin M. Cappuzzo, Steven B. Housley, Muhammad Waqas, Andre Monteiro, Ryan M. Hess, Elad I. Levy, and Adnan H. Siddiqui
8 Robotic-Assisted Endovascular Intervention . . . . . . . 135
Marcus Wong and Gavin Britz
9 Present Rationale and Future Directions
for Intracranial Aneurysm Screening and Rupture Risk Prediction: The Road to Precision Surgery for Intracranial Aneurysms . . . 147
Abhijith R. Bathini, Maged Ghoche, Seyed Farzad Marou, Brandon A. Nguyen, Maria José Pachón- Londoño, Ataollah Shahbandi, Devi P. Patra, and Bernard R. Bendok
10 Endovascular Management and Treatment
of Acute Ischemic Stroke . . . . . . . . . . . . . . . . . . . . . . . 177
Omer Doron, Yafell Serulle, Likowsky L. Desir, Hamza Khilji, and Rafael Ortiz
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239