Come and join us across the globe
The 2023 edition of LINNC Paris began with a potent mix of Live Cases from international centers, provocative special sessions chosen by the Course Directors as well as informative industry sponsored sessions.
Live case from Tunisia
We started this years conference with a live case transmission from the Mongi-Ben Hamida National Institute of Neurology, Tunis, Tunisia presented by the team of Nadia Hammami. This case involved the treatment of a sacular paraophthalmic aneurysm with flow diverter stenting. Laurent Spelle and Jacques Moret along with the expert panel commented on the best way for stent sizing, work positioning, deploying a flow diverter and possible complications of the treatment.
Course Director’s choice - innovation
This case was followed by a new offering at LINNC, the special “Course Director’s choice Innovation Session” in which Alejandro Berenstein presented a new device – remote-controlled microcatheters – and posed the question of whether they were useful or a revolution. He illustrated the question by showing multiple interesting cases of intrasaccular devices deployed with the help of these remote-controlled microcatheters followed by an expert panel discussion on the pros and cons of this technique.
Live case from Bicêtre Hospital, Paris
We then moved to a live case from Bicêtre Hospital in Paris involving two right MCA bifurcation aneurysms (one recurrent clipped and the other a de novo aneurysm) that were treated with flow diverter stenting. Laurent Spelle, Cristian Mihalea and Adrian Popica explained in detail how to use the computer software for stent sizing and decision-making.
Jacques Moret discussed his experience concerning the importance of a test occlusion before flow diversion in bifurcations as well as discussing anti-aggregation. We were left reflecting on the experience and skills of the international panel which discussed treatment indications for flow diversion and other different treatment options.
Live case from Tunisia
The morning session that followed returned to the Mongi-Ben Hamida National Institute of Neurology, Tunis, Tunisia and the team of Nadia Hammami team who led another live case transmission, this one concerning the treatment of a parietal lobe AVM which had previously bled using liquid embolic material.
Jacques Moret and the expert panel had an indepth discussion on indications for AVM embolization. Should we wait or treat it right away after bleeding? They also discussed different treatment options, imaging, and techniques that could be used to avoid liquid embolic material reflux as well as improving nidus occlusion (such as the “pressure cooker” technique or balloons).
Sponsored Symposium
This was followed by a sponsored symposium presented by Laurent Pierrot on surface-modified flow diverters with results from his study (COATING) illustrated by a variety of different cases and their results. Then, Raul G. Nogueira presented his revealing study on stent thrombectomy (PROST). Afterwards, Stavropoula Tjoumakaris spoke about “Endovascular Management of Cerebral Aneurysms: Complications and Management”, letting us know that we can always learn from our successes and complications. Prof. Moret reminded us to always perform a CT scan right after the procedure to assess possible complications.
Live case from Bicêtre Hospital - Paris
As Monday morning ended we jumped back to Bicêtre Hospital for an interesting live case of a left MCA aneurysm treated with a flow diverter stent through radial access performed by Laurent Spelle and the Bicêtre team. Professors Spelle and Moret detailed the 3D model generated by Sim&Cure, the computer tool for stent sizing and deployment planning, and discussed the reasons to treat with a flow diverter instead of an intrasaccular device. Jacques Moret reminded us that the best treatment should always take into consideration the knowledge of the operator, and he went on to note the good results of flow diverter stenting and the evolution of this device and technique.
Clots and Occlusions
During the afternoon presentations, we learned about clot studies from the RESTORE Registry presented by Karen Doyle. Franziska Dorn, in a sponsored symposium, presented a new stent device for thrombectomy from the SPERO Study on clot composition.
Live case from Bicêtre Hospital - Paris
Following this we returned to Bicêtre Hospital where Léon Ikka performed an embolization of a right M1 aneurysm using another new flow diverter stent through radial access after showing the sizing and planning of the intervention using the Sim&Cure simulation. Professors Moret and Spelle and the expert panel had a heated debate over the pros and cons of adding aneurysm sac coiling to flow diverter treatment.
Sponsored Symposium
After the live case, Tommy Andersson gave an illustrated talk on “Remodeling technique – a blessing with a risk?”. He wisely stated the challenges of teaching new neurointerventionalists, which was seconded by Jacques Moret who reiterated the need for interventionalist certification.
Live case from Toronto
Following this it was the turn of the new LINNC Course Co-director, Vitor Mendes Pereira to perform a live case from Saint Michael’s Hospital, Toronto, Canada of a transvenous “pressure-cooker” AVM embolization with liquid embolic through arterial and venous access. Prof. Spelle discussed the tips and tricks of venous navigation and the usefulness of a 3D tool along with other imaging tricks of nidus control of the embolization. The Course Directors and the expert panel then went on to have an in-depth discussion of AVM embolization techniques and their possible complications.
Sponsored Symposium
In this symposium, Christophe Cognard presented the conclusions from the CLEVER study for intrasaccular devices with their good results for ruptured and unruptured aneurysms. Then Johann du Plessis presented the FRED-X European multicenter series.
Live case from Bicêtre Hospital – Paris and Toronto
We ended the first day of LINNC with a live case from Bicêtre with the treatment of a Pcom aneurysm using an intrasaccular device through radial access performed by Jildaz Caroff and Bicêtre team. The Course Directors and the expert panel discussed the skills involved in intrasaccular device deployment and possible complications.
Vitor Mendes Pereira performed an embolization of a previously coiled giant MCA bifurcation aneurysm using an intrasaccular device and flow diverter stent.
Professors Laurent Spelle and Jacques Moret ended the day by following up on the live cases that had been treated during the previous LINNC, while we started looking forward to a second full day from this international state of the art Course for neurointerventionists!
Be sure to join us!
Helio de Paula Carvalho