The Development of Neuroangiography and Its Role In Cerebrovascular Surgery

Abstract Neuroangiography, a specialized imaging technique for visualizing cerebral blood vessels, has been a transformative tool in the diagnosis and treatment of cerebrovascular disorders such as aneurysms, arteriovenous malformations (AVMs), and strokes. Since its inception in the early 20th century, neuroangiography has evolved from high-risk, invasive procedures to advanced, minimally invasive techniques that have greatly improved diagnostic accuracy and surgical outcomes. The development of cerebral angiography by Egas Moniz in 1927 marked a significant milestone, enabling physicians to visualize intracranial vessels for the first time. Subsequent advancements, including the introduction of digital subtraction angiography (DSA) in the 1970s, revolutionized the field by providing clearer, high-resolution images with reduced risk to patients. DSA remains the gold standard for diagnosing cerebrovascular conditions, particularly aneurysms and AVMs. More recent innovations, such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA), have further refined the ability to detect and treat cerebrovascular diseases with greater precision and safety. Additionally, neuroangiography has played a critical role in guiding endovascular treatments, such as aneurysm coiling and AVM embolization, and in stroke management through procedures like thrombectomy. Emerging technologies, including augmented reality and machine learning, promise to further enhance the accuracy and effectiveness of neuroangiography in the years to come. This review highlights the historical development of neuroangiography and its enduring impact on cerebrovascular surgery.