Come and join us across the globe
The conference started off with Vitor Mendes Pereira presenting a stroke case from Toronto for a proximal M2 occlusion. The clot was retrieved with a combination stent retriever and aspiration technique. Laurent Spelle and Vitor Mendes Pereira poll the audience about their preferred technique for endovascular thrombectomy: most have shifted to aspiration thrombectomy.
Arkadii Ivanov, an attendee from Russia, showed his case of coiling of a basilar tip aneurysm. The planning for this case was difficult on account of the multiple areas of stenosis in proximal carotids and vertebral arteries.
Going back to our recorded cases, Laurent Spelle showed a case from Paris of an anterior communicating artery aneurysm treated with a WEB device. This demonstrated how repositioning of the WEB can help avoid ischemic complications due to vessel occlusion. Going to another presentation from an attendee, Pratik Shah from Mumbai presented a case of a delayed presentation stroke from a dissection. The patient did well despite having a large core infarct even at presentation.
Vitor Mendes Pereira presented a large intracranial aneurysm case from St. Michael’s Hospital treated with stent placement. He demonstrated intraluminal stent visualization within the flow diverter using optical coherence tomography (OCT). Laurent Spelle inquired about the clinical utility of OCT, to which Vitor Mendes Pereira illustrated that the technology allows differentiation between intimal hyperplasia and thrombus.
For the first shunting lesion of the day, Laurent Spelle showed a case from Paris. The dural fistula was expertly treated with the Phil liquid embolic. Follow-up angiograms going into 2 years showed that the fistula was fully closed. The case emphasised the importance of doing a complete angiogram for planning.
For Day 2 ’s first industry sponsored lecture by Stryker, James Caldwell talked about thrombectomy for distal occlusions. Data from randomised trials demonstrated less hemorrhage with aspiration alone.
Laurent Spelle presented a case of a wide-neck anterior communicating artery aneurysm treated with Y-stent–assisted coiling. Although there was a transient reduction in flow in one A2 segment during the procedure, the vessel remained patent. Follow-up angiography performed several months later demonstrated complete aneurysm obliteration.
The next case was a giant left ICA aneurysm. This was treated by a non flow diverting stent and coils. While there was aneurysm recurrence at 6 months, there was complete occlusion after ticagrelor was discontinued. This radiologic outcome was durable 2 years in.
Moving on to our pre-lunch industry sponsored symposium, Azmi Abd Kadir Khairul talked about the Siemens angiosuite. He emphasised the synergy of the machine with simulation software. This is vital for high level planning for cases.
After lunch, we were presented with a case of a dissecting aneurysm of the left vertebral artery. The patient was initially diagnosed with aseptic meningitis but imaging revealed intradural dissection. This was treated with a Pipeline flow diverter with the choice of size guided by simulation software. The case emphasised that the radial force of the Pipeline is usually enough to open narrowed dissected segments.
The next case was a ruptured arteriovenous malformation. This was treated with a liquid embolic. Despite intraprocedural rupture, the malformation was closed, and no adverse clinical sequelae occurred. We had a good discussion about the way detachable microcatheters are removed. Laurent Spelle emphasised that there is not only one right way of doing it—fast or slow.
Thien Nguyen Tat, an attendee from Vietnam, showed his case of a complex superior sagittal sinus fistula. With careful planning and protection of the sinus with a large ballon he was able to close the fistula with both coils and a liquid embolic agent. The next case was presented by Nguyen Minh Duc. This was a ruptured artery of Heubner aneurysm. The small distal aneurysm was embolised with glue. The last presentation from an attendee was from Raweenut Beangklang of Thailand. She showed a large and very complex fistula that caused intracerebral hemorrhage. Her case emphasised the important phenomenon of cardiac arrest during embolisation that can be from a vagal reflex and will usually resolve once the catheter is removed.
After the attendee presentations, Laurent Spelle showed pictures of the places he went to in Vietnam as a young boy. This culminated in him coming back later in life to do cases and collaborate with Vietnamese colleagues.
Vitor Mendes Pereira brought us back to cases. He showed a complex left middle cerebral artery aneurysm located at a trifurcation. This was treated with Y stent and coiling. Though there was intraprocedural rupture, the operator expertly managed this by ensuring that the coiling catheter was not pulled out and further coiling closed the aneurysm. This case was followed by another middle cerebral artery bifurcation aneurysm treated with a Contour device.
After the afternoon break, awards for the best cases by attendees were announced: Quang Anh Nguyen, from Vietnam, won for best oral presentation for his work on “How to face up with an un-opened device in deploying flow-diverter”, along with a scholarship to LINNC Paris 2026. Chowdam Venkata Sai Teja won the best poster award for “Hyperacute Hyperperfusion in ICAD stenting”, and a scholarship for LINNC Asia 2026 in Singapore.
For the final cases session, Vitor Mendes Pereira presented a Left P2 ruptured dissecting aneurysm. This was treated with a Fred Jr flow diverter. The aneurysm was successfully shut down with durable outcomes more than a year out. This closes out LINNC Asia 2025!
Reported by Jose Danilo B Diestro
