Come and join us across the globe
After an excellent and interesting first day at the LINNC Seminar Asia edition in Seoul, South Korea, we are very pleased to welcome you for the second day of this exciting Course in neuroradiology!
The first case of the morning was presented by Dr Noufal BASHEER and concerned the management of a growing basilar aneurysm in a 5-year-old child. Treatment for this kind of large aneurysm is never easy, and flow diversion could be a good solution, though antiaggregation in children is not yet clarified.
We then turned to our first case from Bicêtre Hospital which was about the recanalisation of a communicant artery aneurysm treated by a flow diverter. The first stent was not well-positioned in the artery, so Dr Christian MIHALEA decided to catch the device - a technique which is also not easy but was performed successfully here.
Continuing with our series of “Best Cases” submitted by attendees, Dr Thanawat SITTIBUNCHARKORN presented a rare case of dissecting aneurysms by flow diverter using a telescopic technique; an awesome strategy with very good angiographic results.
Course Director Prof. Laurent SPELLE then demonstrated for the attendees the treatment of a left parietal AVM followed by a discussion focused on the indications for AVM treatment looking at such points as the ARUBA study and the question of not treating unruptured AVMs.
Prof. Vitor MENDES PEREIRA, also a LINNC course director, presented a case of a tricky large aneurysm in a young male which was treated by telescopic flow diversion, reconstruction of the carotid artery and with the middle cerebral artery treated using 5 flow diverters.
Clearly, telescopic treatment was the keyword of this morning’s session with OCT being used to visualize the good apposition of the various flow diverters employed.
Our coffee break was followed by a lecture about the use of a thrombus aspiration catheter presented by Dr James CALDWELL. This new 088 catheter, with microcatheter integrated (coaxial systems), could be a very promising system for aspiration first protocols.
Dr Jildaz CAROFF presented the management of a right M1 occlusion using the BADASS Technique (the use of a balloon guiding catheter and stent) to remove the clot and rescue this patient. The stroke session continued with a lively discussion on such topics as the analysis of a clot during the treatment.
Pr Laurent SPELLE closed the stroke session with a discussion about dissection and the different rescue techniques which can be employed.
Using truly awesome 3D pictures, Prof. SPELLE showed us the use of a flow diverter in a very distal, left middle cerebral artery with reconstruction and VasoCT: Did you know that it was feasible and possible to reconstruct this distal and small vessel?
The afternoon session began with a case from Bicêtre team - small dissecting aneurysms in the basilar artery treated by coils and flow diversion. The decision to treat was taken after multiple DSA showed the evolution of a small irregularity on the culprit vessel.
Small AVM parietals were presented using a venous approach with Pr Jacques MORET explaining how to manage the venous approach in order to occlude the nidus and veins. He also discussed the difference between glues in terms of their viscosity. He concluded that navigation into a venous vessel is more difficult than arterial navigation.
Dr Nhat Huy NGUYEN DAO reported on a “Best Case” submission which looked at stenting in a cerebral vein thrombosis. Progression of the catheter was not easy, but after deploying the stent the situation improved. It’s important to share the fact that stenting venous thrombosis could deeply improve the clinical condition of a patient.
Dr William JAMES reported on a case of cavernous fistula treated by a double approach - surgical and endovascular.
After these two very interesting and well presented case reports, Prof. Jacques MORET discussed recanalisation using a stent in first-coiled aneurysms. An open-cell design stent could be a good alternative to retreating communicant artery aneurysms.
Prof. MORET insisted on the anatomical differences between osteo-dural AVMs and lepto-meningeal malformations, underlining the anatomical variations and differences.
The award for “Best Case was given to Dr Vivek LANKA from India who will be invited next June to Paris for the LINNC PARIS 2024 COURSE !.
So, once again, our Course Directors Jacques, Laurent and Vitor were compelling teachers, providing us all with intensive, in-depth lessons on Interventional Neuroradiology along with insights into our professional lives.
So, it is time now for all of us to go back home, where we will be waiting to welcome you to springtime in Paris - and the next LINNC PARIS sessions.
Thank you all and thank you Professors!
Report by Dr Sophie GALLAS