The second day began with an explosion of clinical information and we were catapulted directly into an interesting discussion by Dr Stylianos RAMMOS (Little Rock, AR, USA) who presented a case of a pre-operative targeted embolization of a ruptured cerebellar AVM.
Dr Branden CORD (New Haven, CT, USA), presented a case of open surgical access of a cervical ICA for the treatment of a right CCA symptomatic stenosis through ICA retrograde puncture. An excellent example of a combined surgical and endovascular approach.
This was followed by Dr Ayman ZAKARIA (Doha, Qatar), who presented a case of a giant dural fistula.
Management and treatment strategies were extensively discussed by the participants.
Prof Jacques MORET introduced the case of a non-traumatic high-flow vertebro-vertebral fistula in a 6-year-old patient that was treated using a telescopic flow diverter stent and coiling. Concerns were raised about antiplatelet therapy in young patients, and discussed in full.
The morning continued with the presentation of two cases involving the recurrence of giant aneurysms, with a lively discussion on how they should be treated.
This was followed by an informative “Tips and tricks” session on the art of the “Y stenting technique” for use in the treatment of bifurcated aneurysms.
Another difficult case of an acute stroke presenting with mild neurological symptoms and bilateral large vessel occlusions was introduced to the participants and underlined the challenge of clinical situations where decision-making is far from obvious.
Prof. Jacques MORET explained the necessity of adapting a clear strategy during the treatment of ruptured AVMs with deep venous drainage: from targeted embolisation to a complete occlusion.
Then Prof. Laurent Spelle described the management of intraprocedural complications of aneurysmal perforations in patients receiving dual antiplatelet therapy.
Many thanks go to Dr. Ashish KUMAR (Toronto, Canada) for offering us an interesting case of a large distal aneurysm on the MCA branch and Dr Jason Wenderoth (Sydney, Australia), for an instructive presentation on the percutaneous trans-orbital approach to embolization of a cavernous sinus dural fistula.
There was a challenging case involving a basilar tip aneurysm treated with web device protrusion in the PCA which required acute rescue stenting. Then the day’s session ended with a truly amazing case of spinal dural fistula embolization.
Again we want to thank all the participants for sharing their experiences during these two very intense days in New York City.
Thank you all for having followed this Seminar and we look forward to seeing you all again for the next LINNC seminar…or at LINNC Paris in June!
Valerio DA ROS and Simon ESCALARD - France