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Endovascular Neurosurgery for Cerebral Aneurysms: Coils, Glue, and Stents

Since the introduction of Guglielmi detachable coils (GDCs) (Boston Scientific/Target Therapeutics) in the early 1990s, endovascular treatment of intracranial aneurysms has become a valid alternative to surgery in selected patients. Endovascular treatment is not without its limitations, however. One of these is its inability to completely “pack” the three-dimensional space of the aneurysm, especially in wideneck aneurysms as well as large and giant aneurysms. During the past few years, coil modifications, newer intracranial stents, and liquid embolic agents have been introduced to eliminate some of the limitations of more traditional coils. This article reviews the status of intracranial aneurysm embolization, with special emphasis on recent coil modifications and new devices, and summarizes future potential therapeutic avenues.