Therapeutic advances in interventional neurology

Characteristics of highly cited articles in cerebral angiography

OBJECTIVE

To present and analyze the characteristics of the 100 most cited articles that used cerebral angiography for clinical evaluation and intervention.

METHOD

Two researchers independently extracted articles from multiple databases and ranked them by citation count to create the "top 100 most-cited" list.

RESULTS

The top 100 articles received a total of 115,243 citations. Twenty-one of the top 100 articles were published between 2006 and 2010. Most studied disorder was ischemic stroke (n = 35), and cerebral angiography was used most frequently for diagnosis (n = 88).The United States was affiliated with the highest number of articles (n = 62), with Stroke publishing most articles (n = 22). Public sources funded 39 articles, private sources funded 35, and 38 articles reported conflicts of interest. Thirty-six studies were randomized controlled trials, and male authors held the majority of both first (n = 90) and senior (n = 88) authorship positions.

CONCLUSION

Within the scope of this study, the following features may define a typical highly cited article-a randomized controlled clinical trial conducted in the United States that studied ischemic stroke, used cerebral angiography for diagnosis, and was published relatively recently in a high-impact journal by male first and senior authors.

The interventionalism of medicine: interventional radiology, cardiology, and neuroradiology

Interventional medical practitioners are specialists who do minimally invasive procedures instead of surgery or other treatment. Most often, these procedures utilize various imaging and catheterization techniques in order to diagnose and treat vascular issues in the body. Interventionalist techniques, including injecting arteries with dye, visualizing these via x-ray, and opening up blockages, developed from early pioneers' bold and sometimes controversial experiments which aimed to find safer and better ways to treat coronary artery and other atherosclerotic vascular disease. Currently, the major interventional specialties are interventional (or vascular) radiology, interventional cardiology, and endovascular surgical (interventional) neuroradiology. All three are perfecting the use of stents and other procedures to keep diseased arteries open, while also evaluating the application these procedures. The rapid new development of imaging technologies, mechanical devices, and types of treatment, while certainly beneficial to the patient, can also lead to ambiguity regarding specific specialty claims on certain techniques and devices. While these practitioners can be in competition with each other, cooperation and communication are the most advantageous methods to deal with these "turf wars." All of the interventionalists are needed to deliver the best medical care to patients, now and in the future.

Interventional neuroimaging

Interventional neuroimaging procedures are becoming more effective and safer. This article discusses the therapeutic benefits of endovascular procedures for commonly encountered clinical situations in cerebrovascular disease and brain tumors and then briefly discusses the advances in interventional neuroimaging modalities. Each topic is subdivided into prevalence/natural course, techniques/interventions, summary of clinical trials, and current guidelines/recommendations from professional organizations, whenever applicable.