• Vascular Malformation

 “Alea Jacta Est”

(The Die is Cast)

Gaius Julius Cesar, January 10, 49 BC

Over the last two decades there has been a revolution in the treatment of cerebrovascular diseases. The innovative approach of interventional radiology to a minimally invasive endovascular treatment of vascular diseases has been successfully translated into the vascular neurosurgery realm. A major step in this direction was the Food and Drug Administration (FDA) approval of the Guglielmi Detachable Coils (GDC) on September 8, 1995.1 ,2 Twenty years later, five multicenter randomized clinical trials provided Class 1, Level A evidence that endovascular thrombectomy is the standard of care for patients with acute ischemic stroke secondary to large vessel occlusion. These tremendous advancements in the treatment of cerebrovascular diseases successfully elevated the field of neuroendovascular surgery (NES) to the level of a new and ground-breaking medical specialty.3–7

One of the questions of a new fast-developing field is who are the physicians that have the skills to practice and teach NES? In the USA, physicians terminating residencies in the specialties of radiology, neurosurgery, and neurology started practicing this novel specialty. NES became designated as a subspecialty …