Frontiers in Endovascular and Interventional Neurology (FEIN): Grand Challenges – Looking Ahead

With great challenges comes great opportunities and we personally are greatly optimistic about the prospect of field of endovascular and interventional neurology field. This field has been paved by pioneers from Neurology, Neurosurgery and Radiology worldwide who put us at a very unique stage ready for the next level of achievements and milestone by motivated neuro-interventionalist, vascular neurologists, neuro-intensivists and vascular neurosurgeons worldwide. The past two decades have seen the rise of Neuro-interventional specialty and discipline worldwide, especially with in United States and Europe. Simultaneously we have seen a greater number of clinician such as neurologists and neuro-surgeons becoming neuro-interventionalists; joining the interventional neuro-radiologist colleagues in the endovascular management of cerebrovascular diseases. Back in 1991 it was estimated that only five neurologists were performing interventional procedures but today Society of Vascular and Interventional Neurology (SVIN) has registered around 100 neurointerventional Neurologists and about 10–12 are being trained every year. Most neurologists were trained by interventional neuro-radiologists and endovascular neuro-surgeons. Today, the field is advanced by all three specialties. Moreover, the advances and remarkable achievement in the field would have not been possible without the scientific contribution of the three specialties as well as the vascular neurologists, who are advancing the field with randomized controlled trials such as the PROACT, MELT, IMS, and ISAT trials to promote evidence based medicine in the neuro-interventional procedures. (Furlan et al., 1999; Molyneux et al., 2002; IMS II Trial Investigators, 2007; Ogawa et al., 2007) Such trials take the field to new frontiers that would excel the clinical practice and move it forward. The following are some of the short and long term challenges the field of neurointervention, endovascular and interventional neurology need to over come.