23rd Annual
Interventional Neuroradiology Symposium
& 8th Annual Karel G. Terbrugge Lectureship & Neurovascular Anatomy Workshop
September 28-30, 2023 – 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 – Choroidal Arteries, Perforator Anatomy and associated vascular diseases
At the end of this day, participants should be able to:
- Recognize the normal and abnormal angioarchitecture of the Choroidal arteries and perforators and their variations.
- Identify the role that the choroidal arteries and perforators have in different vascular abnormalities such as aneurysms, AVMs, stenoses and dissections.
- Assess potential risks and complications of endovascular treatment from the choroidal arteries and perforators.
Karel Terbrugge – The limbic arterial circle
Date: Thu, Sept 28, 2023 Time: 0900 – 0930
After active engagement in this session, the participants should be able to:
- Recognize normal as well as variations of the normal intracranial vasculature at the level of the limbic circle.
- Recognize normal as well as variations of the normal intracranial vasculature at the level of the anterior choroidal and posterior cerebral arterial systems.
- Evaluate the variable origins of the anterior choroidal and posterior cerebral arterial systems and assess the shifting and transfer of their territories.
Allan Taylor – The anterior choroidal artery
Date: Thu, Sept 28, 2023 Time: 0930 -1000
After active engagement in this session, the participants should be able to:
- Identify the embryological significance of the anterior choroidal artery.
- Analyze the structures receiving blood supply from the anterior choroidal artery.
- Assess the potential complications of embolizing the anterior choroidal artery.
Hidetsugu Maekawa – The posterior choroidal arteries
Date: Thu, Sept 28, 2023 Time: 1000 – 1030
After active engagement in this session, the participants should be able to:
- Describe the anatomical and embryological aspects of the posterior choroidal arteries.
- Assess the clinical implications of the posterior choroidal arteries and its role in different vascular diseases and their treatment.
Timo Krings – CASE DISCUSSIONS Working in and close to the Anterior Choroidal Artery
Date: Thu, Sept 28, 2023 Time: 1100 – 1130
After active engagement in this session, the participants should be able to:
- Assess the different types of diseases affecting the anterior choroidal artery.
- Analyze different endovascular and surgical management strategies of diseases affecting the anterior choroidal artery.
- Describe the salient imaging features of diseases affecting the anterior choroidal artery.
Johanna Fifi – CASE DISCUSSIONS Vein of Galen Malformations
Date: Thu, Sept 28, 2023 Time: 1130 – 1200
After this session, the participants should be able to:
- Analyze the imaging findings and angioarchitecture of Vein of Galen Malformations.
- Formulate the best treatment plan for the example cases.
- Recognize potential complications of treatment and management.
Pascal Mosimann – CASE DISCUSSIONS Limbic AVMs
Date: Thu, Sept 28, 2023 Time: 1200 – 1230
After this session, the participants should be able to:
- Analyze the clinical and imaging findings and angioarchitecture of Limbic AVMs.
- Formulate the best treatment plan for the example cases.
- Recognize potential complications of treatment and management.
Maksim Shapiro – Anterior Circulation (Lenticulostriate) Perforators
Date: Thu, Sept 28, 2023 Time: 1330 – 1400
After this session, the participants should be able to:
- Describe the anatomical and embryological aspects of the lentriculostriate perforators and variations of their territorial supply.
- Assess the clinical implications of the lentriculostriate perforators and its role in different vascular diseases and their treatment.
Hidetsugu Maekawa – Brainstem Perforators of the Vertebral and Basilar Arteries
Date: Thu, Sept 28, 2023 Time: 1400 – 1430
After this session, the participants should be able to:
- Describe the anatomical and embryological aspects of the brainstem perforators
- Assess the clinical implications of the brainstem perforators and their role in vascular diseases and its treatment.
Eef Hendriks – PCA Perforators
Date: Thu, Sept 28, 2023 Time: 1430 – 1500
After active engagement in this session, the participants should be able to:
- Describe the embryology of the PCA perforators.
- Interpret the normal anatomy of the PCA perforators, their variations and territories.
- Analyze the PCA perforators clinical implications in various vascular diseases and its treatment.
Timo Krings – CASE DISCUSSIONS Tips and Tricks for ICAD Treatment close to perforators
Date: Thu, Sept 28, 2023 Time: 1530 – 1600
After active engagement in this session, participants will be able to
- Identify the relevant neurovascular anatomy for safe endovascular treatment of ICAD.
- Analyze and select the best method to treat each ICAD example case.
- Assess potential complications in endovascular ICAD treatment.
Pascal Mosimann – CASE DISCUSSIONS Tips and Tricks for Perforator Shunt & Aneurysm Embolization
Date: Thu, Sept 28, 2023 Time: 1600 – 1630
After active engagement in this session, the participants should be able to:
- Identify the relevant neurovascular anatomy for safe endovascular treatment through the perforators.
- Analyze and select the best endovascular method for treatment in each example case.
- Assess potential complications of endovascular treatment through the perforators.
Yong Sam Shin – CASE DISCUSSIONS Posterior Fossa Dissections
Date: Thu, Sept 28, 2023 Time: 1630 – 1700
After active engagement in this session, the participants should be able to:
- Identify treatment indications for posterior fossa dissections.
- Choose and compare different treatment strategies according to the lesions.
Day 2 – INR Symposium
At the end of this day, participants should be able to:
- Discuss the pros and cons and ethical issues of using new devices in interventional neuroradiology.
- Recognize the clinical manifestations and imaging features of unusual or controversial neurovascular diseases such as Pure arterial malformations and Moya Moya disease and discuss their treatment options.
- Apply knowledge of new imaging techniques and devices for management of neurovascular diseases.
Patrick Brouwer – New Devices – What the INR needs to know about Regulations
Date: Fri, Sept 29, 2023 Time: 0800 – 0830
After active engagement in this session, the participants should be able to:
- Explain why regulators do not always benefit patients.
- Recognize the need for neurointerventionalists for providing the regulators with the criteria for evaluation.
- Discuss the process, difficulties, and cost of developing a new device.
Thomas Liebig – The Contour Device
Date: Fri, Sept 29, 2023 Time: 0830 – 0900
After active engagement in this session, the participants should be able to:
- Discuss the FDA clinical trial(s) for the Contour device.
- Recognize the Contour Device Design and compare with similar other devices.
- Assess the example cases and the pros and cons of using the Contour device in each case.
Ansaar Rai – The Trenza Device
Date: Fri, Sept 29, 2023 Time: 0900 – 0930
After active engagement in this session, the participants should be able to:
- Describe the FDA clinical trial(s) for the Trenza device.
- Recognize the Trenza Device Design and compare with similar other devices.
- Assess the example cases and the pros and cons of using the Trenza device in each case.
Adel Malek – Endovascular Therapy of Hydrocephalus
Date: Fri, Sept 29, 2023 Time: 0930 – 1000
After active engagement in this session, the participants should be able to:
- Describe the rationale and mechanism of endovascular therapy of hydrocephalus.
- Discuss the current clinical trial and up to date result for the eShunt system that is used to treat hydrocephalus.
- Assess the example cases and pros and cons of using the eShunt system in each case.
Hidetsugu Maekawa – Cerebral Proliferative Angiopathy – More questions than answers
Date: Fri, Sept 29, 2023 Time: 1030 – 1055
After active engagement in this session, the participants should be able to:
- Describe the classic definition and characteristics of cerebral proliferative angiopathy.
- Assess the issues surrounding “cerebral proliferative angiopathy” and choose its proper management.
Brian vanAdel – Pure Arterial Malformations
Date: Fri, Sept 29, 2023 Time: 1055 – 1120
After active engagement in this session, the participants should be able to:
- Recognize clinical manifestations and imaging findings of pure arterial malformations.
- Discuss the management of the example cases.
Timo Krings – Thrombus, Wall enhancement and Edema in Brain AVMs
Date: Fri, Sept 29, 2023 Time: 1120 – 1145
After active engagement in this session, the participants should be able to:
- Recognize why it is important to understand the vessel wall in patients with brain AVMs.
- Choose current imaging strategies to visualize vessel wall pathology in AVMs.
- Identify features that pose an AVM at risk for subsequent rupture.
Hugo Andrade – Vascular Supply in Moya Moya
Date: Fri, Sept 29, 2023 Time: 1145 – 1210
After active engagement in this session, the participants should be able to:
- Identify imaging characteristics and angioarchitecture of Moya Moya Disease.
- Discuss treatment options for patients with Moya Moya disease.
- Analyze and select the best treatment for each example case.
Naoki Kaneko – Flow Stress in Aneurysms
Date: Fri, Sept 29, 2023 Time: 1300 – 1330
After active engagement in this session, the participants should be able to:
- Describe the association between flow stress and the formation and growth of intracranial aneurysms.
- Analyze the effect of flow stress in aneurysms with different locations and morphological variations.
- Justify if and/or when flow stress models can be used as an indicator for aneurysm treatment.
Ivan Radovanovic – Liquid Biopsies for Shunting Lesions – Rationale, Technique, Initial Results
Date: Fri, Sept 29, 2023 Time: 1330 – 1400
After active engagement in this session, the participants should be able to:
- Describe the role of liquid biopsy and its indications.
- Apply the use of liquid biopsy to shunting lesions and vascular malformations.
- Discuss the initial results of liquid biopsy in shunting lesions.
Emanuele Orru – Flowdiversion for Bifurcation Aneurysms
Date: Fri, Sept 29, 2023 Time: 1400 – 1430
After active engagement in this session, the participants should be able to:
- Discuss basic concepts of flow diversion and how they apply to true bifurcation aneurysms.
- Interpret the current available data on distal flow diversion with emphasis on bifurcation aneurysms.
- Discuss the technical aspects and assess the current available devices that are suited each individual indicated case.
Vitor Pereira – Remote Technologies in the Angio Suite
Date: Fri, Sept 29, 2023 Time: 1430 – 1500
After active engagement in this session, the participants should be able to:
- Recognize different types of remote technologies in the Angio Suite and their indications.
- Discuss the pros and cons of using remote technologies and justify the ethical issues related to its use.
Alain Weill – CASES: How I approach wide necked aneurysms – Cases from Montreal
Date: Fri, Sept 29, 2023 Time: 1530 – 1600
After active engagement in this session, the participants should be able to:
- Discuss the different treatment options for wide necked aneurysms.
- Analyze and select the best method of treatment in each example case.
- Assess potential complications of endovascular treatment.
Waleed Brinjikji – CASES: How I approach Disorders of CSF dynamics – Cases from Mayo
Date: Fri, Sept 29, 2023 Time: 1600 – 1630
After active engagement in this session, the participants should be able to:
- Describe the clinical manifestation and pathomechanism of CSF dynamics disorders.
- Discuss the use of endovascular treatment in disorders of CSF dynamics.
- Analyze the method of treatment in each example case and assess its potential complications.
Yong Sam Shin – CASES: How I approach Blood Blister Aneurysms – Cases from Seoul
Date: Fri, Sept 29, 2023 Time: 1630 – 1700
After active engagement in this session, the participants should be able to:
- Interpret literature reviews for the history of BBA treatment.
- Compare surgery versus endovascular treatment for BBAs.
- Assess current endovascular techniques using various stents and their pros and cons.
Day 3 – INR Symposium
At the end of this day, participants should be able to:
- Discuss recent advances in occlusive diseases.
- Examine and choose treatment strategies for patients with stroke.
- Analyze and discuss the challenges of being an interventional neuroradiologist – including diversity, physician wellbeing, ethics, social media and the learning curve.
Joanna Schaafsma – Decision Making in Chronic Occlusive Disease
Date: Sat, Sept 30, 2023 Time: 0800 – 0830
After active engagement in this session, the participants should be able to:
- Describe the clinical manifestations of chronic occlusive disease.
- Explain the management options for chronic occlusive disease.
- Describe decision-making strategies in the absence of solid evidence.
Brian vanAdel – Endovascular Management for proximal supra-aortic Stenoses
Date: Sat, Sept 30, 2023 Time: 0830 – 0900
After active engagement in this session, the participants should be able to:
- Describe the clinical manifestations and imaging findings of proximal supra-aortic stenoses.
- Recognize the indications and discuss the technique for endovascular management of proximal supra-aortic stenoses.
Christine Hawkes – Antiplatelet Treatments in EVT: Whom When What to give
Date: Sat, Sept 30, 2023 Time: 0900 – 0930
After active engagement in this session, the participants should be able to:
- Compare and contrast the available antiplatelet treatments used in EVT
- Analyze the available evidence for their use in EVT
- Demonstrate the importance of antiplatelet treatments in EVT cases.
Robert Fahed – Studies on low Aspects, low NIHSS and distal Occlusions – An update
Date: Sat, Sept 30, 2023 Time: 0930 – 1000
After active engagement in this session, the participants should be able to:
- Discuss the results of studies on low Aspects, low NIHSS and distal occlusions.
- Apply the study results to clinical cases.
Ronit Agid – Diversity amongst INR Practioners in Canada
Date: Sat, Sept 30, 2023 Time: 1030 – 1050
After active engagement in this session, the participants should be able to:
- Identify if there is diversity among INR practitioners in Canada.
- Discuss about women’s status in INR practice in Canada.
- Assess the general status of INR centres in Canada and their approach to diversity.
Patrick Nicholson – Physician Wellbeing in INR – It’s a Marathon, not a Sprint
Date: Sat, Sept 30, 2023 Time: 1050 – 1110
After active engagement in this session, the participants should be able to:
- Identify signs of burnout in themselves and colleagues.
- Analyze different strategies to help cope with their workload and prevent burnout in the long term.
Seon Kyu Lee – Innovation and Ethics
Date: Sat, Sept 30, 2023 Time: 1110 – 1140
After active engagement in this session, the participants should be able to:
- Describe Ethical Considerations in Medical Innovation.
- Assess potential implications of the Conflict of Interest in Medical Research.
- Assess potential implications of the Conflict of Interest in Medical Practice.
Nima Kashani – Branding and Networking with the Media – A guide for Neurointerventionalists
Date: Sat, Sept 30, 2023 Time: 1140 – 1200
After active engagement in this session, the participants should be able to:
- Describe how social media can be used in interventional neuroradiology.
- Assess the pros and cons of social media in interventional neuroradiology.
- Identify the ethical issues associated with use of social media.
Allan Taylor – KTB LECTURESHIP – The Learning Curve
Date: Sat, Sept 30, 2023 Time: 1300 – 1330
After active engagement in this session, the participants should be able to:
- Discuss the origin and theory of the learning curve.
- Apply the ethical principles of teaching in medical procedures.
- Devise a method of reaching and sustaining an acceptable level of procedure performance throughout ones’ career.
Decision Making in Acute Stroke: Tough Cases
Genevieve Milot – Quebec, Jeremy Rempel – Edmonton, Bijoy Menon – Calgary, Will Guest – Vancouver
Date: Sat, Sept 30, 2023 Time: 1330 – 1500
After active engagement in these sessions, the participants should be able to:
- Recognize variations in acute stroke presentations.
- Practice clinical decision making in acute stroke situations from the example cases.
- Explain the current best practices in acute stroke care.
CONTACT INFORMATION
For questions, please contact
Sasikhan Geibprasert (cnrcourse@gmail.com) or Dr. Timo Krings (timo.krings@uhn.ca)