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Case-based Interventional Neuroradiology

With this text, Krings and colleagues have attempted to take a subspecialty-level textbook and pare it down to the essentials using a case-based format. Gone are the introductory chapters describing techniques for arterial access and the plethora of available catheters. What remains is a remarkably thorough and well-organized text that holds the reader’s attention better than any traditional textbook.

The case-based format lends itself well to the material. Each case begins with a clinical vignette, reviews the pertinent imaging findings to establish the diagnosis, and then details the procedure performed, including the technique and materials used. Images are used sparingly throughout the case to illustrate the diagnosis or key procedural steps. The authors then step back and discuss the diagnosis, treatment, and complications. In particular, they concisely review the relevant literature on treatment options in an unbiased manner and provide a select list of references.

The text includes 72 cases, organized into 10 parts based loosely on diagnoses. As expected, more than half of the cases cover variations in diagnoses or treatments of aneurysms, arteriovenous malformations, or shunts. Other topics include stroke, trauma, preoperative tumor embolization, and even percutaneous spinal interventions, ranging from intra-articular facet injections to vertebroplasty. Of note, cases focused on the recognition and management of common complications, such as mechanically induced vasospasm or periprocedural thrombus formation in aneurysm coiling, are also included.

Shortcomings are minor. The images are small and arrows would occasionally be helpful, but these are common problems in radiology texts. The focus of each case is clearly the treatment, in line with the authors’ goal. The diagnostic aspect of the case is kept to a minimum, but as a consolation, the book comes with a subscription to an online collection of diagnostic neuroradiology cases.

Overall, this text is a concise but remarkably complete review of a large variety of diagnoses, treatments, and complications relevant to the interventional neuroradiologist. As such, this text will be most useful to residents or fellows pursuing specialty training in neuroradiology or neurosurgery, particularly those with an interest in endovascular techniques. Those already in practice will likely find it useful as a concise and up-to-date review and appreciate the perspective from a highly experienced, international group.

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