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The neurointerventionalist and the AdvaMed Code of Ethics: examining the doctor–device industry relationship
  1. Christopher White1,
  2. Carolyn Brugera2,
  3. Joshua Hirsch3
  1. 1AdvaMed, Washington, District of Columbia, USA
  2. 2Micrus Endovascular Corporation, San Jose, California, USA
  3. 3Interventional Neuroradiology/Endovascular Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Christopher White, 701 Pennsylvania Ave NW, Suite 800, Washington DC 20004, USA; cwhite{at}advamed.org

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Introduction

The specialty of neurointerventional (NI) surgery is one of the most rapidly advancing and exciting areas of medicine today—in part based on close relationships with industry that ignite rapid advances. But, close relationships present a risk of conflict of interest. This article discusses a reasonable approach to manage conflict of interest while preserving opportunity for innovation.

Advancing medical technology

Thanks to advances in medical technology, neurointerventionalists are able to treat a wide array of conditions that occur within the vessels of the brain or spinal cavity, such as aneurysms, strokes and spinal compression fractures. As a relatively nascent specialty, the NI field has developed in an era of technological innovation. Inherent in that development are continuing refinements in the tools used to image and treat patients with these technologies. The field has thus advanced alongside developments by a vibrant and intellectually active medical device industry. Historically, NI physicians have often worked collaboratively with their industry partners to help move the field forward to the benefit of patients. Moreover, if it were not for the ongoing collaboration between NI surgeons and the medical technology industry, many of these advanced treatments used every day in neurointerventional surgery would not exist. Guglielmi detachable coils are an example of an innovation that has led to significant improvements in care and quality of life for patients where industry chose to forever honor the physician counterpart by associating the product with his name.

In comparison with other life sciences sectors, the medical device industry presents unique conflicts-of-interest considerations based on product complexity and constant product evolution. NeuroIntervention has at its core some of the most life-threatening disease states and high-risk treatment options. The dynamic process of innovation and factors such as product delivery technique refinement, education, testing and clinical trials, and product support, all make it necessary for ongoing …

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