Endovascular Neurosurgery in Europe and in Italy: What Is in the Future?

BACKGROUND: The cerebrovascular discipline has undergone dramatic changes in recent years. This has been made possible by the work of pioneers in the fields of neurosurgery and neuroradiology. METHODS: In this article we review the evolution and fundamental stages that led to the birth of endovascular treatment and discuss why, also in Europe, this treatment must be included in neurosurgery, encouraging the training of endovascular neurosurgeons who can collaborate with their interventional neuroradiology colleagues in order to form unbiased surgeons who understand the disease from both the endovascular as well as the surgical prospective. We examine how the new generation of European cerebrovascular specialists, including neurosurgeons, neuroradiologists, and some neurologists, will attain their requisite endovascular training. Finally, we briefly review the current state of endovascular neurosurgery in Europe and in Italy and speculate about what its role will be in the near and distant future. CONCLUSIONS: To remain at the forefront of evaluating, caring for, and treating patients with cerebrovascular disease, vascular neurosurgery must evolve toward a specialty, mastering the knife as well as the catheter. We think it is time for European neurosurgeons to start training residents in endovascular neurosurgery in the same way we train neurosurgeons in every other neurosurgical discipline.