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Shades of BENESTENT in the Aneurysm World

This article was originally published in Start Up

Executive Summary

UK investigators' recent decision to call an early halt to enrollment in a major study comparing neurosurgical clipping to endovascular coil treatment of ruptured cerebral aneurysms may signal a significant change of practice habits in a critical area of neurology. The findings, if they're as good as they appear to be, could do to surgical clipping and endovascular coils what the BENESTENT trials of the early 1990s did to promote stenting over balloon angioplasty in patients with coronary artery disease.

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Neuroendovascular devices for treating hemorrhagic and ischemic stroke, while investigational, are gaining attention because of technology advances, intriguing anecdotal evidence of efficacy in a field in which previous drug therapies haven't worked, and positive but controversial emerging clinical data. Companies are pursuing neuro applications of endovascular devices, but despite lots of noise, clinical challenges and uncertain market potential restrain many from investing heavily in the field.

Interventional Neuroradiology's Growing Pains

Neuroendovascular devices for treating hemorrhagic and ischemic stroke, while investigational, are gaining attention because of technology advances, intriguing anecdotal evidence of efficacy in a field in which previous drug therapies haven't worked, and positive but controversial emerging clinical data. Companies are pursuing neuro applications of endovascular devices, but despite lots of noise, clinical challenges and uncertain market potential restrain many from investing heavily in the field.

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The young and hybrid specialty of interventional neuroradiology is pushing to assume a leadership role in treatment of acute neurovascular disease. Interventional neuroradiologists are the endovascular experts who attempt to do for the brain what interventional cardiologists do for the heart. Their success has ijmplications for device companies, which are eyeing the field but hesitant to commit heavily to it because of concerns about market size and infrastructure.

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