Embolic materials for endovascular treatment of cerebral lesions

Recently developed soft microcatheters can be maneuvered endovascularly into the brain, permitting treatment of lesions without conventional neurosurgery. Progress in biomaterial science has contributed significantly to the development of this new therapeutic modality termed intravascular neurosurgery or interventional neuroradiology. Although embolic materials play an important role, ideal materials have yet to be devised. Various embolic materials in clinical use are reviewed, such as cyanoacrylates, ethylene-vinyl alcohol copolymer mixtures, Ethibloc, ethanol, estrogen, poly(vinyl acetate), cellulose acetate polymer, poly(vinyl alcohol), gelatin sponges, microfibrillar collagen, surgical silk sutures, detachable balloons, and coils. The materials are reviewed in the context of treatment application for various brain lesions, such as arteriovenous malformations, cerebral aneurysms, and head and neck tumors. Further developments in biomaterial polymer science can bring about progress against brain diseases.