Each patient’s welfare is paramount.
Clinical decision-making should be based on sound judgment and the best available clinical data. New medical technology and drugs should be used within reason, and whenever possible, based on established principles of sound practice.
While we have the technology and the ability to coil aneurysms in very old patients with Hunt Hess V subarachnoid hemorrhage, embolize asymptomatic and low-risk dural AV fistulas, and perform carotid angioplasty and stenting in patients with asymptomatic stenosis, we should recognize the value of conservative management when it is called for.
The clinical outcome of each case takes priority over “pushing the envelope” by trying out new devices or techniques, generating material for the next clinical series or case report, or satisfying the device company representatives standing in the control room.
Harrigan MR & Deveikis JP
Handbook of Cerebrovascular Disease and Neurointerventional Technique, 2023
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