In recent years, with the rapid development of neuroimaging, catheter technology and materials, computers and other sciences, endovascular interventional techniques have become increasingly mature in the treatment of cerebrovascular disease, and are recognized by physicians and patients for their minimally invasive, safe, and effective features, and have now become one of the important treatments for cerebrovascular disease. The following areas are of particular interest to clinicians. Interventional treatment of intracranial aneurysms Interventional treatment of intracranial aneurysms began in the early 1970s. In the early days, interventional treatment was only applicable to patients whose aneurysm morphology and location were not suitable for surgical clamping or whose clinical status was poor. With the continuous improvement of catheter technology and embolization materials, interventional techniques have gradually matured and now become an important method for the treatment of intracranial aneurysms. A recent multicenter randomized clinical trial, the International Subarachnoid Aneurysm Trial (ISAT), compared endovascular spring coil embolization with neurosurgical clamping and showed that the former method The results showed that the former method improved the patient’s chances of living independently 1 year after surgery. The treatment of unruptured aneurysms is still controversial internationally and requires a comprehensive assessment of the risks and benefits of interventions and a management plan based on individual patient differences. Foreign literature suggests that interventional therapy can reduce the risk of rupture in the natural course of unruptured aneurysms, but further studies are needed to confirm the exact conclusion. The improvement of the safety and effectiveness of interventional therapy undoubtedly depends on the development of new technologies and materials. In recent years, on the basis of GDC electrolytic detachable spring coils, a variety of new materials for intracranial aneurysm embolization have emerged, such as three-dimensional spring coils, biologically coated spring coils, water-expandable spring coils, liquid embolic agents, and auxiliary materials such as intracranial stents and sealing balloons used in conjunction with the Coil-retention Technique (CRT). CRT is a technique that uses the “basket-forming” nature of three-dimensional spring coils or adjunctive measures such as balloons, stents, and dual microcatheters to reconstruct the aneurysm neck so that the spring coils remain securely in the aneurysm cavity, with the goal of isolating the aneurysm from the circulation while preserving the aneurysm-carrying artery. This technique is mainly used for intracranial wide-necked or shuttle-shaped aneurysms. The combined application of multiple embolization techniques and materials has broadened the indications for interventional treatment of intracranial aneurysms and further improved the therapeutic effect. It is believed that with the progress of material science and methodology as well as the accumulation of clinical experience, interventional therapy is expected to become the treatment of choice for intracranial aneurysms. 2. Interventional treatment of cerebral arteriovenous malformation N-butyl cyanoacrylate (NBCA) has been used for more than ten years as a representative of adhesive liquid embolic material for interventional treatment of cerebral arteriovenous malformation. Neurointerventional physicians have gained a great deal of experience in this area, making it possible to reduce the flow of cerebral arteriovenous malformations after embolization and then to make them suitable for surgical resection or radiation therapy, and also to cure some lesions by embolization alone. The advent of Onyx, a non-adhesive liquid embolization material, has changed the status quo of NBCA in the interventional treatment of cerebral arteriovenous malformations, and it can even be said that the application of Onyx is another milestone in the history of neurosurgical interventional materials after the introduction of GDC detachable spring coils. EVOH is a non-adhesive embolic material that is insoluble in water and dissolves in DMSO. It becomes a permanent embolic material at the target site. Due to the non-adhesive nature of Oynx, theoretically the microcatheter will not be stuck in the lumen, allowing the operator to push Onyx for a longer period of time and wait for the Onyx to disperse widely in the malformation mass, thus improving the embolic effect. The basic consensus reached at home and abroad is that the application of Onyx has increased the cure rate of cerebral arteriovenous malformation intervention embolization from about 15% to 41%, and the complete embolization rate of cerebral arteriovenous malformation with Spetzler-Martin grade 1-2 is as high as 90%. The etiology and pathogenesis of dural arteriovenous fistulas remain unclear and may be related to changes in estrogen levels and inflammation or thrombosis of the venous sinuses. Research on dural arteriovenous fistulas has focused on the mode of venous drainage, and many foreign scholars have proposed a new typology. At present, domestic and foreign clinical studies recognize that transvenous approach is indeed effective in treating dural arteriovenous fistulas, especially for dural arteriovenous fistulas in the cavernous sinus area, and the venous approach can be the first choice. With the advancement of microcatheterization, some rare venous accesses have been tried, such as trans-pterygoid plexus, trans-superficial temporal vein and, if necessary, direct puncture of the venous sinus. Transarterial route Onyx embolization for dural arteriovenous fistulas is another promising advancement in the field of neurosurgical interventions. Current phase I clinical studies have shown that Onyx embolization for dural arteriovenous fistulas in the transverse-sigmoid sinus region is reliable and is being applied progressively to arteriovenous fistulas in the cavernous and sagittal sinus regions. The combination of arterial and venous routes is expected to solve the worldwide problem of dural arteriovenous fistula in neurosurgery. Beijing Institute of Neurosurgery has done a lot of clinical work and accumulated some experience in the treatment of dural arteriovenous fistula through arterial and/or venous route embolization. 4.Interventional treatment of ischemic cerebrovascular disease Carotid stenosis in the extracranial segment is a common disease and a common cause of ischemic stroke. In recent years, treatment of carotid stenosis has received increasing attention. The pathophysiological mechanisms of ischemic stroke events caused by intracranial atherosclerotic stenosis are much more complex than those of extracranial ones, including perfusion loss, thrombosis of unstable plaques or intraplaque hemorrhage, arterial embolism, and perforator embolism. Intracranial stenting may be an important treatment alongside antithrombotic therapy and bypass surgery, but a preoperative benefit and risk assessment is necessary. Patients with imaging and clinical evidence of distal perfusion deficit are expected to benefit from stentoplasty. In those with penetrating branch ischemia within the stenotic segment alone, stentoplasty may outweigh the benefits by pushing plaque into the opening of the penetrating branch and causing a stroke. In patients with both penetrating ischemia and distal perfusion loss, the advantages and disadvantages need to be fully evaluated. Improvement of the stenting process and long-term follow-up after stenting will be the focus of further research and hot topics. It should be noted that interventional neuroradiology has come a long way under the guiding ideology of minimally invasive and safety, but with rapid progress. Today, interventional techniques have become an important force in the treatment of cerebrovascular diseases in neurosurgery and neurology, and are gradually developing into an independent discipline. With the improvement of treatment concept, the development of new materials and the popularization of core technologies, neurointerventional therapy will certainly have a broader development.