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Endovascular and Percutaneous Therapy of the Brain and Spine

Duke University Medical Center Durham, NC 27710

Edited by Michael P. Marks and Huy M. Do. Philadelphia, PA: Lippincott Williams & Wilkins, 466 pp., 2002. $149.95

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The task of composing a multiauthor text on interventional neuroradiology is a difficult one because the process may be protracted, and the field is still rapidly evolving, which means that once the book is published, it may already be out of date. Although this may be true in certain respects for Marks and Do's Endovascular and Percutaneous Therapy of the Brain and Spine, it is nevertheless an excellent reference text on neurointerventional endovascular therapy.

The book focuses on the major interventional topics in detail: ischemic disease, aneurysms, arteriovenous malformations and fistulas, tumors, head and neck abnormalities, and spine interventions. It was written by acknowledged experts in the fields of interventional neuroradiology, neurosurgery, and stroke neurology. Overall, the quality and number of angiograms—CT and MRI—and additional figures are appropriate for this type of textbook.

The organization of the book follows a logical pattern initially, with overview chapters on ischemic stroke, aneurysms, and arteriovenous malformations in each section by experts in stroke neurology and neurosurgery. However, there are no overview chapters in the remainder of the sections, making the latter a little less structured. I enjoyed reading the overview chapters in the initial sections, and I think they will provide an excellent primer on these topics for residents or fellows and a good refresher for more experienced clinicians. These chapters, however, do focus more on the surgical or neurologic aspects of the vascular disorder and by themselves would not seem to fit in this book on endovascular and percutaneous therapy.

There are several technical innovations in the neurointerventional field that were available at the 2002 publication date that were not included in the book. Although the chapter on cerebral aneurysm treatment goes into some detail on the polymer-coated Matrix coil, it does not discuss the coated Hydrocoil, which fills aneurysms by actual expansion of the coil through hydration. Likewise, the aneurysm section does not discuss the new intracranial self-expanding Neuroform stent, specifically designed for intracranial wide-neck aneurysm treatment. There are also newer microsnares that have better trackability than the Microvena Goose Neck snare discussed in the ischemic disease section.

The chapter on intracranial atherosclerotic disease is heavily biased toward angioplasty only (without stenting) for intracranial arterial stenosis. Although I realize this is the authors' clinical preference, there is only brief mention of intracranial stents for this disorder, and there are no case examples of intracranial stenting in the figures. Yet the reader should be wary of accepting angioplasty as the standard of care because many interventionists across the nation use balloon-expandable stents for this disorder. No well-controlled studies have shown superior efficacy of either technique to date, so the debate will continue. However, the introduction of drug-coated stents for coronary disease to decrease restenosis rates may provide an attractive alternative for intracranial use in the future.

Finally, the spine section is a nice review of spinal interventions, endovascular and percutaneous. This section, albeit short, was not included in many previously published interventional neuroradiology books.

Overall, I found the book had some flaws, including virtually no mention of pediatric vascular intervention (e.g., vein of Galen malformations) or clinical biases, which are minor, but the general quality of the book is excellent.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Alexander, M. J. Search for Related Content PubMed Articles by Alexander, M. J. Social Bookmarking                      What's this?