The professional detonator: Intracranial aneurysmal pathology

The title may seem aggressive and caricatural, but it perfectly reflects the determination of the protagonists to defend their ‘turf’ on the one hand, and a revolutionary and essentially transgressive concept on the other, the principle of which had yet to be proven and implemented through technological innovation. The first twenty years of endovascular treatment of intracranial aneurysms (1970-1990) were chaotic, because from idea to implementation, there was a time lag in technological development. Then came the GDCs (Guglielmi Detachable Coils), whose ingenuity was matched only by the humility of its eponymous inventor. There was now no turning back from success, as demonstrated by the ISAT (International Subarachnoid Aneurysm Trial) study in 2005. Since then, the therapeutic consensus has been established, and 30 years after Guido Guglielmi and 20 years after ISAT, the patient remains the main beneficiary of this revolution.