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For the first time, LINNC China joined forces with the Shanghai Neurointervention Forum and the Annual Meeting of the Neurointervention Committee of the Shanghai Medical Doctor Association (SNF) to offer three exceptional days of education and exchange in neurointerventional medicine.
Day 3, the final day of the conference, highlighted complex stroke, aneurysm, and AVF/AVM cases, emphasizing technical strategy, device selection, and patient safety, alongside robust discussion on procedural complications and outcomes.
The morning began with a 58-year-old female presenting with a right distal M1 occlusion, NIHSS 15, left-sided neglect, hemiplegia, facial droop, and slurred speech. Imaging demonstrated a large perfusion mismatch with a favorable ASPECTS score. The team utilized a balloon-guiding catheter, distal access catheter, stent retriever, and aspiration system, favoring direct aspiration of the clot. Despite small distal emboli, the patient achieved near-complete recovery. Faculty discussion focused on distal emboli prevention, thrombolytic timing, and novel imaging tools such as OCT and impedance sensors to characterize clot composition. Consensus emphasized rapid thrombectomy as first-line therapy, with intravenous thrombolytics reserved for centers unable to perform mechanical thrombectomy.
The focus then shifted to aneurysm treatment. Prof. Moret presented a 41-year-old female with an incidental intracavernous carotid aneurysm pointing medially toward the weak inner wall of the cavernous sinus. The aneurysm was successfully treated with a Pipeline Vantage 5×14 flow diverter. Post-procedure headaches were noted, attributed to anatomical constraints and minor mucosal hematoma. At 1.5-year follow-up, a small proximal dissection was observed, but the patient experienced full clinical recovery. This case highlighted the importance of anatomical awareness and long-term surveillance when deploying flow diverters in sensitive regions.
Prof. Li Qiang discussed experiences with domestic flow diverters for bifurcation aneurysms, presenting two cases. The first involved a 61-year-old female with a right MCA multilobulated aneurysm, treated with a flow diverter and coils, complicated by temporary stent stenosis after discontinuation of dual antiplatelet therapy, but the patient returned to normal function after resuming therapy. The second case involved a 73-year-old female with a large ACom aneurysm, successfully treated with the domestic Choydar flow diverter and coils while protecting critical branches. These cases emphasized the importance of compliance with antiplatelet therapy, careful device selection, and procedural planning for bifurcation anatomy.
Returning to stroke interventions, Prof. Laurent Spelle presented a 47-year-old male with mild aphasia and NIHSS 1, who experienced a wake-up stroke. Mechanical thrombectomy was performed using a Trevo XP ProVue stent retriever and aspiration system, achieving first-pass success. Faculty debated the clinical indications for distal thrombectomy in low-NIHSS patients, referencing the MeVO trial, and discussed anesthesia considerations in ongoing research protocols.
Day 3 concluded with reflections on clinical lessons and best practices. Rapid, targeted thrombectomy remains critical for distal MCA occlusions, and distal emboli, while common, are generally manageable. Flow diverters require precise anatomical understanding, careful sizing, and diligent long-term follow-up. Compliance with dual antiplatelet therapy and vigilant post-procedural monitoring are essential to prevent stent-related complications. Patient selection, procedural indication, and realistic goal-setting are crucial, particularly for incidental or complex AVFs, DAVFs, and aneurysms. Multiplanar imaging and routine post-operative CT/XperCT remain vital for early complication detection.
As the conference concluded, it was evident that LINNC China 2025 had successfully fostered a high-level exchange of knowledge, techniques, and innovations in neurointervention. The collaboration with SNF and the Shanghai Neurointervention Committee provided a platform for meaningful discussion, hands-on learning, and the sharing of best practices.
This inaugural joint meeting was a resounding success, advancing neurointerventional education and setting a strong precedent for future collaboration.
Reported by Eileen Liu
