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The second day of this year’s LINNC China began by focusing on stroke and ischemic disease: After Tingyu Yi’s reflections on thrombectomy with double stent in an acute internal carotid artery occlusion, Pengyu Pan shared a very interesting case of recurrent restenosis of multiple intracranial stenosis in the anterior circulation in a young patient, underlining the importance of vessel wall imaging.
Intracranial stenosis resulting from ICAD and its management was the topic of the case presentations by Huaizhang Shi, Liangfu Zhu and Peng Gao.
Then Guangzhong Chan presented a very interesting case of a ruptured basilar artery aneurysm in a pediatric patient with an aortic arch malformation, an interrupter aortic arch and an aberrant right subclavian artery. This malformation induced an increased flow in the brain circulation with flow inversion in both vertebral arteries and multiple flow-related intracranial aneurysms. After endovascular treatment of the ruptured aneurysm, the patient underwent surgical aortic arch repair and the follow-up DSA showed a regression of the intracranial aneurysms.
After two industry-sponsored symposiums by Accumedical about the Lattice flow diverter, and Stryker about the Surpass flow diverter, Laurent Spelle and Jacques Moret presented the first two recorded cases on this second day: The treatment of a small ruptured ACOM aneurysm with an endo-saccular flow diverting device, and the treatment of a distal ruptured dissecting aneurysm of the M4 segment with a flow-diverter stent going through a 17 microcatheter, giving the occasion of instructive discussions among the participants and the faculty.
Then Vitor Mendes Pereira presented a recorded case from Toronto, a giant fusiform aneurysm of the M1 segment of MCA in a pediatric patient, treated by parent artery reconstruction with flow diverters placed in telescopic manner and consecutive partial coiling of the aneurysm sac through a jailed microcrater.
This case gave him the occasion to demonstrate once again the major contribution of the OCT to the understanding and monitoring of the stent placement and guide the intrastent balloon angioplasty.
Later this day, Jacques Moret and Laurent Spelle presented two more recorded cases of aneurysm treatments with intra-saccular devices, covering the entire spectre of the three available devices in Europe, the WEB, the Artisse, and the Contour, and discussed the differences and advantages of each one of them. The faculty members agreed that those devices are the future for treating bifurcation aneurysms.
During the last industry-sponsored symposium of the day by Balt, Quiang Li discussed the strategy for curative brain AVM embolization based on its angioarchitecture. Jacques Moret also illustrated this topic with another recorded life case of the transvenous treatment of a small ruptured cortical parietal AVM, and the faculty members discussed the best follow-up strategy after an angiographically complete AVM treatment.
Throughout the day, the level of attention, participation and engagement on the part of the attendees was notably high, leading to valuable exchanges, like at the presentation of some of the best cases submitted by attendees: Changya Liu presented a treatment of a direct carotid-cavernous fistula
with covered stents delivered through an intermediate catheter (the so-called Trojan Horse technique), Tony Chan discussed the difficulty to treat giant fusiform basilar artery aneurysms, and Wenhuo Chen shared a case of a chronic ICA occlusion recanalization with the BASIS technique plus the use of intraoperative OCT.
Then, Ming Wang shared with us a case of endovascular recanalization of a subacute right middle cerebral artery occlusion, Chao Lin a treatment of an MCA bifurcation aneurysm associated with a tight upstream stenosis, and Guoli Duan a lateral sinus dural AVF embolization with venous remodelling followed by stenting of this sinus for tight stenosis.
Among the many excellent cases presented by the attendees over these 2 days, Jiaxin Huang won the prize for best paper and a grant to attend the next LINNC in Paris in June 2025.
Laurent Spelle concluded this year’s meeting with a very instructive recorded case of the endovascular treatment of a recurrent ACOM by bilateral flow-diverter reconstruction of the anterior cerebral artery to exclude the ACOM hemodynamically. The treatment featured more pitfalls than expected, since the vessel anatomy made the sizing and stent placement very difficult, underlining the importance of having a simulation software tool.
We are forward to seeing you all for the LINNC-Seminars and the LINNC Paris in 2025!
Reported by Eileen Liu and Léon Ikka
