22nd Annual
Interventional Neuroradiology Symposium
& 7th Annual Karel G. Terbrugge Lectureship & Neurovascular Anatomy Workshop
September 22-24, 2022 – BMO Education & Conference Centre, Toronto, CA (Hybrid)
Co-Organized by the Department of Medical Imaging, University of Toronto and the Department of Diagnostic Imaging, Hospital for Sick Children (SickKids)
Learning Objectives
Day 1 – External Carotid Artery and Spinal Vascular Anatomy and Diseases
At the end of this day, participants should be able to:
- Recognize the normal and abnormal angioarchitecture of the external carotid artery (ECA) and spine region.
- Use the above knowledge to formulate a differential diagnosis of various vascular abnormalities in these regions – including vascular tumors, AVMs and dural AVFs.
- Compare different treatment options and discuss the best treatment strategy for each vascular disease patient.
Presenters
Kim Nelson – ECA Embryology
Date: Thurs, Sept 22, 2022 Time: 0800 -0830
After this session, the participants should be able to:
- Describe the embryology that leads to different anatomical variants of the ECA
- Analyze different variations of the ECA and how they may impact treatment and clinical outcome in intracranial vascular diseases.
Maksim Shapiro – The ascending pharyngeal artery
Date: Thurs, Sept 22, 2022 Time: 0830-0900
After this session, the participants should be able to:
- Name the possible territories of the ascending pharyngeal artery and its cranial nerve supply.
- Recognize the dangerous anastomoses between the ascending pharyngeal artery and intracranial arteries.
- Discuss the safest route of treatment for tumors and various vascular diseases based on the above knowledge.
Maksim Shapiro – Meningeal Arteries
Date: Thurs, Sept 22, 2022 Time: 0900-0930
After this session, the participants should be able to:
- Recognize the normal territories and variations of the meningeal arteries.
- Identify when and where the arteries of the brain can participate in the supply of the dura.
- Apply the above knowledge in dural lesion interventions.
Karel Terbrugge – CASE DISCUSSIONS Epistaxis
Date: Thurs, Sept 22, 2022 Time: 1000-1030
After this session, the participants should be able to:
- Recognize the clinical and imaging characteristics of the various causes of epistaxis.
- List the indications and contraindications for endovascular management of epistaxis
- Name the transcranial vascular anastomosis and their relevance to endovascular epistaxis treatment.
Waleed Brinjikji – CASE DISCUSSIONS Paragangliomas
Date: Thurs, Sept 22, 2022 Time: 1030-1100
After this session, the participants should be able to:
- Recognize the imaging characteristics and angioarchitecture of Paragangliomas.
- Summarize the risk and benefits of pre-operative embolization for Paragangliomas.
- Discuss different types of embolic materials and their pros and cons for pre-operative tumor embolization.
Timo Krings – CASE DISCUSSIONS Juvenile Angiofibromas (JAF)
Date: Thurs, Sept 22, 2022 Time: 1100-1130
After this session, the participants should be able to:
- Identify the neurovascular anatomy relevant for JAF.
- Review the current methods to treat JAF.
- Identify potential complications in endovascular JAF treatment.
Jai Jai Shankar – CASE DISCUSSIONS Embolizing the MMA: CSDH & Meningeomas / Tips & Tricks
Date: Thurs, Sept 22, 2022 Time: 1130-1200
After this session, the participants should be able to:
- Describe the pathophysiology of chronic subdural hematoma.
- Identify when embolization of middle meningeal artery for treatment of chronic subdural hematoma is indicated.
- Discuss the risks for embolization of middle meningeal artery.
Timo Krings – Spinal Vascular Anatomy
Date: Thurs, Sept 22, 2022 Time: 1300 – 1330
After this session, the participants should be able to:
- Recognize the clinical importance of spinal vascular anatomy.
- State the current imaging strategies to demonstrate spinal vascular anatomy.
- Report clinical symptomatology related to disorders of the venous vascular outflow.
Timo Krings – Classification of Spinal Vascular Diseases
Date: Thurs, Sept 22, 2022 Time: 1330 – 1400
After this session, the participants should be able to:
- Recognize the different types and pathogenesis of spinal vascular diseases.
- Describe the clinical symptomatology of different spinal vascular diseases.
- Diagnoses patients with spinal vascular diseases based on clinical and imaging findings.
Tao Hong – Genetic Pathways in Spinal AVM
Date: Thurs, Sept 22, 2022 Time: 1400 – 1430
After this session, the participants should be able to:
- Recognize the genetic homogeneity in spinal and brain arteriovenous malformations.
- Describe the KRAS/BRAF pathway as the main genetic mechanism of spinal arteriovenous malformations.
- Describe MAP3K3 and PIK3CA as the main genetic mechanism of brain and spinal cavernous malformations.
Donatella Tampieri – Shunting Lesions of the Spine: Imaging
Date: Thurs, Sept 22, 2022 Time: 1430 – 1500
After this session, the participants should be able to:
- Differentiate the different spinal vascular lesions based on their imaging characteristics.
- Combine the above knowledge with the clinical symptoms to formulate the most likely diagnoses for patients with spinal vascular abnormalities.
- Recommend the most appropriate imaging modality for patients with suspected spinal vascular abnormalities.
Joshua Hirsch – A rational approach to Spine Interverventions
Date: Thurs, Sept 22, 2022 Time: 1530 – 1600
After this session, the participants should be able to:
- Identify different Percutaneous discal treatment options, their indications, risks, and how to perform them.
- Debate modern day spinal augmentation with a focused review on mortality.
- Discuss future trends in spine care.
Eef Hendriks – CASE DISCUSSIONS Spinal Dural Arteriovenous fistula (dAVF)
Date: Thurs, Sept 22, 2022 Time: 1600-1630
After this session, the participants should be able to:
- Describe the imaging characteristics of spinal DAVFs.
- State the pros and cons of surgery versus endovascular treatment for spinal dAVFs.
- Recognize the different variant types of spinal dAVF.
Hong Qi Zhang – CASE DISCUSSIONS Spinal AVMs
Date: Thurs, Sept 22, 2022 Time: 1630-1700
After this session, the participants should be able to:
- Recognize the role of embolization in Spinal cord AVM treatment.
- Describe different embolization techniques that can be used in Spinal AVMs.
- Evaluate the outcome of hybrid surgery in Spinal AVM treatment.
Day 2 – INR Symposium
At the end of this day, participants should be able to:
- Integrate the knowledge of transvenous embolizations in the decision making for treatment of various intracranial diseases, including intracranial hypotension, spinal and cranial AVMs and dAVFs.
- Discuss and analyze the current literature for pros and cons in new advances of intracranial endovascular treatment, such as Stentrodes, Flow diversion for distal aneurysms, distal thrombectomy.
- Compare and discuss the different treatment strategies for unusual patients with brain AVMs and dAVFs, including pediatric patients and those with unusual angioarchitecture.
Presenters
Richard Farb – Detecting intracranial Hypotension: the TWH Approach
Date: Fri, Sept 23, 2022 Time: 0800-0820
After this session, the participants should be able to:
- Recognize the clinical symptoms of intracranial hypotension.
- Recommend the appropriate imaging modality for evaluation patients with intracranial hypotension.
- Describe imaging characteristics of intracranial hypotension, particularly those with Cerebrospinal fluid (CSF) leakage.
Transvenous Embolizations for intracranial Hypotension the Mayo Experience
Waleed Brinjikji – Rochester, Patrick Nicholson – Toronto
Date: Fri, Sept 23, 2022 Time: 0820-0840
After this session, the participants should be able to:
- Recognize the indications for transvenous embolization of CSF leaks.
- Examine the example cases and discuss the treatment strategies and their outcomes.
Workup and endovascular Management of Pulsatile Tinnitus
Patrick Nicholson – Toronto
Date: Fri, Sept 23, 2022 Time: 0840-0900
After this session, the participants should be able to:
René Chapot – Transvenous Embolizations for spinal AVMs and spinal dAVFs
Date: Fri, Sept 23, 2022 Time: 0900-0920
After this session, the participants should be able to:
- Recognize the indications and risks for transvenous embolization of spinal AVMs and spinal dAVFs.
- Examine the example cases and identify patients who would benefit from transvenous embolization over transarterial embolization.
René Chapot – Transvenous Embolizations for Brain AVMs
Date: Fri, Sept 23, 2022 Time: 0920-0950
After this session, the participants should be able to:
- Determine the indications and contraindications for transvenous embolization of brain AVMs.
- Detect potential complications from transvenous embolization for brain AVMs.
- Examine the example cases and discuss treatment strategies for each brain AVM patient.
Thomas Oxley – Stentrodes – The story so far
Date: Fri, Sept 23, 2022 Time: 1030-1100
After this session, the participants should be able to:
- Describe what Stentrodes are and how they can be implanted in the brain.
- Identify patients who would likely benefit from Stentrodes.
Andres Lozano – The Neurosurgical Perspective
Date: Fri, Sept 23, 2022 Time: 1100-1130
After this session, the participants should be able to:
- Summarize the concepts of neuromodulation.
- Describe Deep Brain Stimulation and its indications.
- Discuss brain targets for different diseases.
Kartik Bhatia – Relationship of Vascular Structures and Functional Neurosurgical Targets
Date: Fri, Sept 23, 2022 Time: 1130-1150
After this session, the participants should be able to:
- Identify the closest accessible vessels adjacent to neurosurgical targets for brain stimulation.
- Assess the distance between targets and adjacent accessible vessels.
- Choose the best stimulation targets for approach by endovascular means.
Pascal Mosimann – Thrombectomy for distal clots – is there evidence?
Date: Fri, Sept 23, 2022 Time: 1300 – 1330
After this session, the participants should be able to:
- Discuss the current literature about distal thrombectomy and its potential indications.
- Identify possible complications of distal thrombectomy
- Examine and discuss the treatment strategies of the example cases and their outcomes.
Vitor Pereira – Flowdiversion for distal arterial aneurysms (AA) – Is there evidence?
Date: Fri, Sept 23, 2022 Time: 1330 – 1400
After this session, the participants should be able to:
- Discuss the current literature about flowdiversion for distal AAs.
- Describe the pros and cons of treating distal AAs with flowdiverters.
- Identify potential complications of flowdiverters in distal AA treatment.
Daniel Roy – Endovascular Treatment for Brain AVMs – is there evidence?
Date: Fri, Sept 23, 2022 Time: 1400 – 1430
After this session, the participants should be able to:
- Discuss on the wide range of reported success rates of endovascular treatment for brain AVMs in terms of occlusion and complication rates.
- Analyze and interpretate theses rates as reported from the registry sub-group from the TOBAS trial.
J Mocco – Intracerebral hemorrhage (ICH) : A disease that should be treated minimal invasively?
Date: Fri, Sept 23, 2022 Time: 1430 – 1500
After this session, the participants should be able to:
- Describe the concept of aspiration of ICH.
- Identify indications for ICH treatment.
- Report complications associated with ICH treatment.
Timo Krings – CASES: Dural Supply in pial AVMs, pial supply in dural AVFs
Date: Fri, Sept 23, 2022 Time: 1530 – 1600
After this session, the participants should be able to:
- Explain why it is important to understand the pial supply in dural AVF management.
- Explain why it is important to understand the dural supply in pial AVM treatment.
- Identify different subtypes of pial supply in dural AVF.
Ivan Radovanovic – CASES: Combined Surgical and endovascular approaches in AVMs and dAVFs
Date: Fri, Sept 23, 2022 Time: 1600 – 1630
After this session, the participants should be able to:
- Discuss the rationale for combined surgical and endovascular approaches for AVMs and dAVFs.
- Examine the cases and discuss treatment strategies for each patient.
Prakash Muthusami – CASES: Pediatric Shunts – Recent cases, recent developments
Date: Fri, Sept 23, 2022 Time: 1630 – 1700
After this session, the participants should be able to:
- Identify the spectrum of neurovascular arteriovenous shunts in children.
- Discuss the treatment considerations, including the indications and potential complications.
- Differentiate the treatment difference in adults versus children.
Day 3 – INR Symposium
At the end of this day, participants should be able to:
- Discuss recent advances in stroke treatment.
- Examine and choose treatment strategies for patients with stroke.
- Identify the building blocks of an INR service.
- Analyze and discuss the difficulties of being an interventional neuroradiologist.
Presenters
Timo Krings – Anatomical Considerations for Intracranial Atherosclerotic Disease (ICAD)
Date: Sat, Sept 24, 2022 Time: 0800 – 0820
After this session, the participants should be able to:
- Assess the different types of ICAD related stroke mechanisms.
- Review endovascular management strategies of ICAD.
- Report salient imaging features of high-risk anatomies for endovascular ICAD treatment.
Joanna Schaafsma – New Drugs for Stroke Treatment and Prevention
Date: Sat, Sept 24, 2022 Time: 0820 – 0840
After this session, the participants should be able to:
- Describe the risks and benefits of add-ons to thrombolytics in acute stroke.
- Summarize the updates on neuroprotective agents.
- Discuss novel approaches for the secondary prevention of ischemic and hemorrhagic stroke and their indications.
Raul Nogueira – Oxygen Carriers for Acute Stroke
Date: Sat, Sept 24, 2022 Time: 0840 – 0900
After this session, the participants should be able to:
- Identify the different types of oxygen carriers and how they work.
- Summarize the recent studies and their results of the use of oxygen carriers in acute stroke.
- Discuss indications and contraindications of administrating oxygen carriers in acute stroke patients.
Blaise Baxter – Hyperacute Stroke Detection: In-Ambulance CT, Ultrasound or …AI?
Date: Sat, Sept 24, 2022 Time: 0900 – 0920
After this session, the participants should be able to:
- Describe the various tools available for screening and identifying large vessel occlusion (LVO) stroke patients.
- Summarize the strengths and weaknesses of the LVO screening tools.
- Apply how LVO screening tools can be used in stroke networks to gain efficiencies and improve treatment times to revascularization.
Hal Rice – Clot Composition Detection: Why, How?
Date: Sat, Sept 24, 2022 Time: 0920 – 0940
After this session, the participants should be able to:
- Discuss how clot composition can help establish the cause of stroke.
- Associate certain imaging characteristics with different clot compositions.
- Use the knowledge about clot composition to determine the treatment strategy for stroke patients.
Andrew Demchuk – Current trials for Stroke
Date: Sat, Sept 24, 2022 Time: 0940 – 1000
After this session, the participants should be able to:
- Discuss the results of the recently published stroke trials.
- Describe the direction of the new and ongoing stroke trials.
- Predict the future direction of stroke research and management.
Ronit Agid – Women in Interventional Neuroradiology
Date: Sat, Sept 24, 2022 Time: 1030 – 1100
After this session, the participants should be able to:
- Acquire an understanding of the status of women INR physicians.
- Describe the similarities and differences among women and men practicing INR.
- Propose possible ways to include more women in the INR profession.
Ruba Kiwan and Ravinder-Jeet Singh – Building a Stroke Service from 0 to 24 -7
Date: Sat, Sept 24, 2022 Time: 1100 – 1130
After this session, the participants should be able to:
- Describe the development of the EVT service in the Northeast Ontario- from conception to operations.
- Discuss the opportunities and hurdles while developing 24/7 EVT service.
- Identify the current EVT Access Pathways in the Northeast Ontario.
- Review the HSN EVT performance and patient outcomes in the first 2 years.
Transitioning from being a fellow to being Staff: Lessons learned
Will Guest – Vancouver, Jesse Klostranec – Montreal, Emanuele Orru – Boston, Ayman Qureshi – London, Patrick Nicholson – Toronto
Date: Sat, Sept 24, 2022 Time: 1130 – 1200
After this session, the participants should be able to:
- Describe potential problems and challenges in the career transition from fellow to staff – “What I wish I’d known before becoming staff”.
- Discuss potential strategies to maximize success in first few years of career and minimize potential burnout.
René Chapot – KTB LECTURESHIP – How to survive INR
Date: Sat, Sept 24, 2022 Time: 1300 – 1330
After this session, the participants should be able to:
- Describe the problems and challenges of working in the INR field.
- Formulate strategies to succeed in an INR career and minimize potential burnout.
Decision Making in Acute Stroke: Tough Cases
Lissa Peeling – Saskatoon, Brian van Adel – Hamilton, Sachin Pandey – London, ON
Date: Sat, Sept 24, 2022 Time: 1330 – 1500
After these sessions, the participants should be able to:
- Describe the challenges of decision making in acute stroke, its treatment and potential complications and failures.
- Examine the example cases and discuss treatment strategies for each case.
CONTACT INFORMATION
For questions, please contact
Sasikhan Geibprasert (cnrcourse@gmail.com) or Dr. Timo Krings (timo.krings@uhn.ca)