Neural NoiseEndovascular brain-computer interfaces are neural recording and stimulation devices implanted through the vascular system rather than via open craniotomy. A catheter is threaded through a peripheral vein — typically the jugular — into a cerebral blood vessel adjacent to the cortical region of interest, where the device is deployed against the vessel wall. This approach eliminates the need for brain surgery, dramatically reducing implantation risk and enabling same-day or next-day discharge, while still capturing local field potentials and multi-unit activity from nearby cortical tissue through the vessel wall.
The most advanced endovascular BCI is the Stentrode, developed by Synchron and first implanted in human participants in 2020 as part of the SWITCH trial in Australia. The stent-mounted electrode array self-expands inside the superior sagittal sinus, positioning recording contacts within millimetres of the motor cortex. Early clinical data demonstrated that ALS patients could use the device to control digital interfaces — typing emails and browsing the web — by generating motor cortex signals decoded from the endovascular recording. The procedure’s safety profile, comparable to routine interventional neuroradiology procedures, makes it one of the most clinically translatable BCI implantation strategies.
Endovascular BCIs occupy a unique position in the neural interface landscape: they offer better signal quality than non-invasive approaches like EEG while avoiding the tissue damage and immune response associated with penetrating intracortical arrays. Trade-offs include limited spatial resolution compared to penetrating electrodes, restriction to cortical regions accessible via venous anatomy, and the challenge of achieving bidirectional stimulation through vessel walls. As interventional neurovascular techniques advance and electrode miniaturisation continues, endovascular approaches are expected to expand beyond motor BCI into applications such as seizure monitoring, closed-loop neuromodulation, and chronic neural recording for research.