Endovascular neural interfaces: current platforms and clinical readiness

Area of Science:

• Neurointerventional techniques
• Biomedical engineering
• Neurosurgery

Background:

• Conventional electroencephalography (EEG) is limited by skull interference.
• Intracranial implants (electrocorticography, stereoelectroencephalography) carry procedural risks.
• Endovascular approaches offer a middle ground for neural interfaces.

Purpose of the Study:

• Review the evolution and device classes of endovascular neural interfaces.
• Synthesize evidence on implantation, signal characteristics, and clinical applications.
• Provide recommendations for neurointerventional adoption and future development.

Main Methods:

• Narrative review of historical and current endovascular neural interface technologies.
• Emphasis on clinical platforms like Stentrode and EP-01.
• Synthesis of data on deliverability, signal quality, stimulation, and clinical translation.

Main Results:

• Endovascular techniques provide enhanced signal quality over scalp EEG with reduced procedural risks.
• Platforms discussed include stent-electrode arrays and catheter-based electrodes.
• Evidence reviewed covers epilepsy evaluation, brain-computer interfaces, and translational constraints.

Conclusions:

• Endovascular neural interfaces represent a promising advancement in brain activity monitoring and stimulation.
• Further research, registries, and trials are needed for widespread clinical adoption.
• Next-generation device development should address identified translational constraints.