Interventional neuroradiology

He performed the first brain angiography in Lisbon in 1927[3] by injecting an iodinated contrast medium into the internal carotid artery and using the X-rays discovered 30 years earlier by Roentgen in order to visualize the cerebral vessels.

Parallel to the development of catheters, in the radiology and neuroradiology units, image technology dramatically improved: Charles Mistretta in 1979 invented digital subtraction angiography (DSA), the technique currently in use.

Coils replace balloon occlusion Between the end of the 1980s and the beginning of the '90s, INR was suddenly revolutionized after the work of two Italian physicians: Cesare Gianturco and Guido Guglielmi.

[11][12] Flow diversion devices were later developed, with the function of reconstructing the vessel's normal anatomy without directly closing the aneurysm neck and therefore preserving side branches and preventing ischemia.

[16] Between January and June 2015, five major randomized trials were published in the New England Journal of Medicine (NEJM) with the collaboration of interventional neuroradiologists and stroke neurologists (in the Netherlands,[17] Canada,[18] Australia,[19] US[20] and Spain[21]) regarding the role of mechanical thrombectomy in the treatment of ischemic stroke, demonstrating that if it is performed in centers with proven experience, intra-arterial mechanical thrombectomy is more effective than traditional treatment (intravenous thrombolytic injection).

The promising results of these mechanical thrombectomy trials were highlighted by the NEJM in an editorial, which concluded with the statement: "Endovascular equipoise no longer exists.