The LINNC Seminar NEW YORK 2017 got begun!
Our warmest welcome and thanks for joining us at this amazing educational event taking place at the Sheraton Hotel in the iconic center of New York City – Times Square!
The morning session began very early after a warm welcome by Professors Jacques Moret and Laurent Spelle, the Seminar’s historic directors. The first presentation of this year’s LINNC seminar was by Dr Vitaly KISELEV (Novosibirsk, Russia) focusing on the debate surrounding the utility of a combined transarterial and transvenous approach for the treatment of brain AVMs.
Then it was the turn of Dr Fabio Settecase (San Francisco, CA, USA), who presented a case of a posterior circulation stroke due to severe basilar artery stenosis. The rising intensity of the discussion accompanying this case concerned the risks of angioplasty and stenting in an acute setting.
An amazing case of post-traumatic carotid-cavernous fistula followed!
The microcatheter is jailed in the cavernous sinus and a double lumen balloon was used to first deploy a flow diverter stent and, then, to protect the internal carotid artery during Onyx injection.
How and when to best use this technique was explained by Prof. Laurent Spelle.
The morning continued with an impressive pre-recorded case performed by Prof. Jacques MORET.
A ruptured 1.2 mm anterior choroidal aneurysm was treated using a stent remodelling technique. The technical result was fantastic, leading to a discussion on what are the indications for the best strategy – after which we finally had the right answer!
There were continued discussions concerning the treatment of Chinese hat basilar trunk aneurysms as well as concerns about perforator occlusions in the era of flow diverters.
This intense and productive morning approached its end with questions raised about a stroke case with mild neurologic clinical manifestations that was difficult to interpret: Was it vessel stenosis or thrombus? And how should it be managed?
Presented by Dr Orlando DIAZ (Houston, TX, USA), the early afternoon saw an instructive case of percutaneous direct puncture embolization of the hypoglossal foramen dural fistula. This case demonstrated how advances in technology combined with the anatomical knowledge and skills of an experienced operator can overcome the challenge of accessibility in difficult cases of vascular embolization.
Constructive – and passionate – interaction
As we‘ve come to expect, the discussions reached a heightened level in mid-afternoon with a case presented by Prof. Moret on the embolization of a large ruptured AVM with an unfavorable outcome. Divergent opinions offered by some of our most experienced–and eloquent – specialists accented this lively discussion which was followed by “Tips and tricks” offered by Prof. Jacques MORET on the balloon remodelling technique using a flow disruption device.
The afternoon included the results of the STRATIS trial and several very interesting cases presented by Drs. Vladimir KALOUSEK (Zagreb, Croatia) and Dr Athos PATSALIDES (Cornell Medical Center, NYC, NY, USA). Thanks to both of these excellent practitioners.
The afternoon ended with a case illustrating the challenge of navigation posed by flow diverter use in tortuous anatomy. This is a good indication for using the “Shepherd technique”, as suggested by Dr Jason WENDEROTH (Sydney, Australia).
And so today’s first working session arrived at its end.
Now comes the moment to relax, continuing our interchange with other participants and friends as we spend a good time having drinks on the 54th floor of the Hyatt Centric Times Square - a rooftop location with breathtaking views of New York that you shouldn’t miss!
Enjoy the city and see you tomorrow for more exciting cases!
Valerio DA ROS and Simon ESCALARD- France