Purpose:

In recent years, innovations in the neuroendovascular field have introduced multiple novel devices and techniques, greatly expanding the neurointerventionist’s armamentarium. The emergence of novel treatment strategies, such as flow diversion and flow disruption for treating intracranial saccular aneurysms, has improved the versatility and feasibility of treating complex cases endovascularly. As such, endovascular approaches have evolved to become the mainstay of treatment for various cerebrovascular conditions. With the different types of interventions available, it is critical for the diagnostic radiologist to have a current and intimate knowledge of the devices used, including their gross appearance, radiographic appearance immediately post-intervention, and expected evolution over time.

Methods: Describe and discuss the expected and unexpected radiographic appearance of neuroendovascular devices used in the treatment of conditions such as cerebral aneurysms, arteriovenous malformations/fistulas, atherosclerotic disease, and ischemic stroke.

Findings:

This educational exhibit systematically introduces devices commonly used to by the neurointerventionist including coils, stents, Pipeline embolization device (PED), Woven Endobridge (WEB), liquid embolics/particles and stentriever. We show photographs of the devices ex vivo and discuss their underlying treatment principles. Radiographic appearance immediately post-intervention and evolution over time are highlighted. Case-based examples are used to demonstrate unexpected findings and post-treatment complications.

Summary/Conclusion:

Imaging plays a critical role in evaluating the success of endovascular therapy for cerebrovascular conditions and assessing unforeseen complications following intervention. Up-to-date knowledge of the various devices and their appropriate radiographic appearance over time is essential for the diagnostic radiologist, such that potential post-intervention complications can be promptly and accurately recognized.

Neuroendovascular Devices: A Primer for the Diagnostic Radiologist

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