Multiple breakthroughs in mechanical thrombectomy treatments—from robotic systems and modality choices to large-core strokes—feature among NeuroNews’ most popular stories from last month. November also saw experts discuss optimal approaches to managing chronic subdural haematoma (cSDH) and intracranial aneurysms, in addition to the first-ever presentation of long-awaited clinical data from the CREST-2 trial.
1. Weighing up particles, EVOH-based liquid agents and glues in MMA embolisation
With the technique of middle meningeal artery embolisation (MMAe) presently coming of age in cSDH management, Franziska Dorn (Bonn, Germany) outlines how three of the main materials used during these procedures—microparticles, ethylene-vinyl alcohol (EVOH)-based liquid embolic agents and cyanoacrylate glues—appear to stack up.
2. “Historical” CREST-2 data show reduced stroke risk with carotid stenting versus medical therapy alone
The international CREST-2 study has found that, for people with severe carotid artery narrowing who have not experienced recent stroke symptoms, a minimally invasive carotid artery stenting (CAS) procedure—combined with intensive medical therapy—significantly lowered stroke risk compared with medical therapy alone. The more traditional surgical approach of carotid endarterectomy (CEA) did not show the same benefit, however.
3. XCath performs first-in-human brain aneurysm procedures with endovascular robotic system
XCath has announced the successful first-in-human use of its EVR robotic system to treat three patients with complex brain aneurysms. These “landmark” procedures were performed at the Panama Clinic in Panama City, Panama, led by Vitor Pereira (Toronto, Canada) alongside local principal investigator Anastasio Ameijeiras Sibauste, marking what the company describes as “the second time in history” that a surgical robot has been used in an intracranial neurovascular intervention.
4. ATLAS meta-analysis consolidates EVT’s efficacy in large-core stroke with benefits seen across majority of patient subgroups
The efficacy and overall safety profile of endovascular therapy (EVT) in large-core ischaemic stroke patients has been reaffirmed by the findings of ATLAS—a systematic review and meta-analysis of close to 2,000 patients included in six different randomised controlled trials (RCTs) evaluating the procedure.
5. Contact aspiration’s first-pass benefits seemingly “offset” by inferior final recanalisation versus stent retrievers in basilar occlusion stroke
In patients with vertebrobasilar artery occlusion (VBAO) stroke undergoing mechanical thrombectomy, first-line contact aspiration appears to produce a greater first-pass effect (FPE) compared to a stent retriever-only approach. However, stent retriever-first techniques may yield better final reperfusion rates, resulting in no significant difference in overall clinical outcomes between the two. As such, researchers believe that technique selection based on the underlying occlusion aetiology may be critical, and further analyses are warranted to clarify this relationship.
6. Canadian RCT joins growing list of studies demonstrating benefits with MMA embolisation in cSDH management
The findings of EMMA-CAN—the first RCT in Canada assessing embolisation of the middle meningeal artery (EMMA) as an adjunct to surgical drainage in cSDH patients—have shown the approach to be associated with significant reductions in both radiographic and symptomatic haematoma recurrence as compared to surgery alone.
7. Sentante announces successful completion of transatlantic remote stroke intervention
Sentante announced in a recent press release that it has successfully achieved a “first-of-a-kind” remote stroke procedure—performed by specialist surgeons guiding the interventions from different hospitals in Jacksonville, USA and Dundee, UK. Full end-to-end thrombectomies were performed on perfused non-living subjects with procedure-authentic pathology in the Image Guided Therapy Research Facility (IGTRF) at the University of Dundee (Dundee, UK).
8. Kaneka announces European launch of i-ED brain aneurysm embolisation coil
Kaneka Corporation has announced that it has begun sales of its i-ED brain aneurysm embolisation coil in Europe, as of October 2025. The product obtained CE certification under EU Medical Device Regulation (MDR) in July and will be distributed primarily in Europe through Kaneka Medical Europe.
9. Vesalio receives two US FDA 510(k) clearances for aspiration devices
Vesalio recently announced two new US Food and Drug Administration (FDA) 510(k) clearances for its aspiration devices, designed for peripheral and neurovascular applications.
10. Treatment of cerebral aneurysms: an evolving field that has moved towards minimally invasive surgery
As the relationship between endovascular and open surgical approaches to cerebral aneurysm treatment continues to evolve, Edgar Samaniego (Iowa City, USA) discusses the appropriate place for both techniques moving forward.
