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:

  1. Recognize the normal and abnormal angioarchitecture of the Choroidal arteries and perforators and their variations.
  2. Identify the role that the choroidal arteries and perforators have in different vascular abnormalities such as aneurysms, AVMs, stenoses and dissections.
  3. 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:

  1. Recognize normal as well as variations of the normal intracranial vasculature at the level of the limbic circle.
  2. Recognize normal as well as variations of the normal intracranial vasculature at the level of the anterior choroidal and posterior cerebral arterial systems.
  3. 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:

  1. Identify the embryological significance of the anterior choroidal artery.
  2. Analyze the structures receiving blood supply from the anterior choroidal artery.
  3. 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:

  1. Describe the anatomical and embryological aspects of the posterior choroidal arteries.
  2. 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:

  1. Assess the different types of diseases affecting the anterior choroidal artery.
  2. Analyze different endovascular and surgical management strategies of diseases affecting the anterior choroidal artery.
  3. 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:

  1. Analyze the imaging findings and angioarchitecture of Vein of Galen Malformations.
  2. Formulate the best treatment plan for the example cases.
  3. 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:

  1. Analyze the clinical and imaging findings and angioarchitecture of Limbic AVMs.
  2. Formulate the best treatment plan for the example cases.
  3. 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:

  1. Describe the anatomical and embryological aspects of the lentriculostriate perforators and variations of their territorial supply.
  2. 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:

  1. Describe the anatomical and embryological aspects of the brainstem perforators
  2. 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:

  1. Describe the embryology of the PCA perforators.
  2. Interpret the normal anatomy of the PCA perforators, their variations and territories.
  3. 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

  1. Identify the relevant neurovascular anatomy for safe endovascular treatment of ICAD.
  2. Analyze and select the best method to treat each ICAD example case.
  3. 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:

  1. Identify the relevant neurovascular anatomy for safe endovascular treatment through the perforators.
  2. Analyze and select the best endovascular method for treatment in each example case.
  3. 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:

  1. Identify treatment indications for posterior fossa dissections.
  2. 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:

  1. Discuss the pros and cons and ethical issues of using new devices in interventional neuroradiology.
  2. 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.
  3. 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:

  1. Explain why regulators do not always benefit patients.
  2. Recognize the need for neurointerventionalists for providing the regulators with the criteria for evaluation.
  3. 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:

  1. Discuss the FDA clinical trial(s) for the Contour device.
  2. Recognize the Contour Device Design and compare with similar other devices.
  3. 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:

  1. Describe the FDA clinical trial(s) for the Trenza device.
  2. Recognize the Trenza Device Design and compare with similar other devices.
  3. 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:

  1. Describe the rationale and mechanism of endovascular therapy of hydrocephalus.
  2. Discuss the current clinical trial and up to date result for the eShunt system that is used to treat hydrocephalus.
  3. 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:

  1. Describe the classic definition and characteristics of cerebral proliferative angiopathy.
  2. 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:

  1. Recognize clinical manifestations and imaging findings of pure arterial malformations.
  2. 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:

  1. Recognize why it is important to understand the vessel wall in patients with brain AVMs.
  2. Choose current imaging strategies to visualize vessel wall pathology in AVMs.
  3. 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:

  1. Identify imaging characteristics and angioarchitecture of Moya Moya Disease.
  2. Discuss treatment options for patients with Moya Moya disease.
  3. 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:

  1. Describe the association between flow stress and the formation and growth of intracranial aneurysms.
  2. Analyze the effect of flow stress in aneurysms with different locations and morphological variations.
  3. 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:

  1. Describe the role of liquid biopsy and its indications.
  2. Apply the use of liquid biopsy to shunting lesions and vascular malformations.
  3. 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:

  1. Discuss basic concepts of flow diversion and how they apply to true bifurcation aneurysms.
  2. Interpret the current available data on distal flow diversion with emphasis on bifurcation aneurysms.
  3. 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:

  1. Recognize different types of remote technologies in the Angio Suite and their indications.
  2. 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:

  1. Discuss the different treatment options for wide necked aneurysms.
  2. Analyze and select the best method of treatment in each example case.
  3. 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:

  1. Describe the clinical manifestation and pathomechanism of CSF dynamics disorders.
  2. Discuss the use of endovascular treatment in disorders of CSF dynamics.
  3. 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:

  1. Interpret literature reviews for the history of BBA treatment.
  2. Compare surgery versus endovascular treatment for BBAs.
  3. 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:

  1. Discuss recent advances in occlusive diseases.
  2. Examine and choose treatment strategies for patients with stroke.
  3. 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:

  1. Describe the clinical manifestations of chronic occlusive disease.
  2. Explain the management options for chronic occlusive disease.
  3. 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:

  1. Describe the clinical manifestations and imaging findings of proximal supra-aortic stenoses.
  2. 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:

  1. Compare and contrast the available antiplatelet treatments used in EVT
  2. Analyze the available evidence for their use in EVT
  3. 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:

  1. Discuss the results of studies on low Aspects, low NIHSS and distal occlusions.
  2. 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:

  1. Identify if there is diversity among INR practitioners in Canada.
  2. Discuss about women’s status in INR practice in Canada.
  3. 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:

  1. Identify signs of burnout in themselves and colleagues.
  2. Analyze different strategies to help cope with their workload and prevent burnout in the long term.

 

Seon Kyu LeeInnovation and Ethics

Date:   Sat, Sept 30, 2023                                         Time:   1110 – 1140

After active engagement in this session, the participants should be able to:

  1. Describe Ethical Considerations in Medical Innovation.
  2. Assess potential implications of the Conflict of Interest in Medical Research.
  3. 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:

  1. Describe how social media can be used in interventional neuroradiology.
  2. Assess the pros and cons of social media in interventional neuroradiology.
  3. 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:

  1. Discuss the origin and theory of the learning curve.
  2. Apply the ethical principles of teaching in medical procedures.
  3. 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:

  1. Recognize variations in acute stroke presentations.
  2. Practice clinical decision making in acute stroke situations from the example cases.
  3. 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)