PROGRAM March 22-23, 2019 - LINNC€¦ · PROGRAM. March 22-23, 2019. Biltmore Hotel, Coral...
Transcript of PROGRAM March 22-23, 2019 - LINNC€¦ · PROGRAM. March 22-23, 2019. Biltmore Hotel, Coral...
P R O G R A M
March 22-23, 2019Biltmore Hotel, Coral Gables
-Miami, FL, USA-
LINNC SEMINAR - AMERICAS EDITION
LINNC Seminar is a LINNC extensiona Unique Concept with the Same Spirit!
Live Interventional Neuroradiology, Neurology & Neurosurgery Course
www.linnc.com
Phot
o co
urte
sy o
f the
Gre
ater
Mia
mi C
onve
ntio
n an
d Vi
sito
rs B
urea
u, M
iam
iand
Beac
hes.c
om
LINNC SEMINAR 2019 - AMERICAS EDITION
COURSEDIRECTORS
Jacques MORET
Laurent SPELLE
LINNC US Seminar is transformed – and LINNC Americas is born! Finally, the Americas – all the Americas – have their own interventional neuroradiology seminar!
By popular demand, our well-received North American course, LINNC US seminar is expanding its horizons, transforming and becoming LINNC Americas 2019 and taking place in Miami!
This new venue offers the very best for all our participants. Besides being known for its good weather and beautiful beaches, Miami is a leading global city with a reputation in science, research and the arts – a multicultural and dynamic location for LINNC Americas. Well served and offering an easier access to our colleagues from throughout South, Central and North America, our move is in response to what we have heard from participants during our other seminars and underlines the international and cross-border nature of the work we advance together.
Interventional neuroradiology has entered a new maturity and with that comes a renewed commitment from all of us at the LINNC family of neuroradiology, neurology and neurosurgery courses to ensure that the quality of information and the expertise gained from years of practice is effectively transmitted and openly exchanged. To do this, we continually work to develop the curriculum and fine-tune our pedagogical approach so that those who participate in any LINNC seminar come away with a take-home experience that can immediately and positively influence their practice.
Aside from offering a venue for all our colleagues throughout the Americas, the central and motivating force in LINNC Americas will be this very spirit that equally defines all LINNC seminars:
• An open exchange of knowledge and experience;
• The quality, quantity and diversity of the pre-recorded cases. This case library ensures that the interaction with the audience and expert panels will be strengthened by concrete examples designed to illustrate the most complex situations and respond to any of your questions;
• The willingness of all participants, from the leading professors to youngest fellows to learn together.
This is the LINNC spirit and this is – with your participation – why we believe LINNC Americas will be the leading course for interventional neuroradiology, neurology and neurosurgery in the Western Hemisphere!
We wish you a fruitful seminar.
Sincerely,Course Directors
FACULTY
Guiseppe LANZINO
FACULTY
FACULTY & SCIENTIFIC COMMITTEE
Andres ARBELAEZ Hospital Pablo Tobón Uribe
Universidad CESMedellin, Colombia
Michel FRUDIT Hospital Albert Einstein
Sao Paulo, Brazil
Luis A. LEMME PLAGHOS CENBA - Consultorio Endovascular
Neurologico Buenos AiresBuenos Aires, Argentina
Jacques MORET NEURI, the Brain Vascular Center
Bicêtre Hospital - Paris Saclay UniversityParis, France
Elias RABAHI Hospital Santa Mônica
Goiânia, Brazil
Alejandro BERENSTEIN Cerebrovascular Center
The Mount Sinai HospitalNew York, USA
Tudor G. JOVIN Cooper University Hospital
Camden, USA
Italo LINFANTE Miami Cardiac and Vascular Institute
Florida International UniversityMiami, USA
Raul G. NOGUEIRAMarcus Stroke & Neuroscience Center
Grady Memorial HospitalAtlanta, USA
Laurent SPELLENEURI, the Brain Vascular Center
Bicêtre Hospital - Paris Saclay UniversityParis, France
Orlando M. DIAZ Institute for Academic Medicine,
Houston Methodist HospitalWeill Cornell Medical College
Houston, USA
Giuseppe LANZINOMayo Clinic
Rochester, USA
Vitor MENDES PEREIRA Toronto Western Hospital,University Health Network
University of TorontoToronto, Canada
Ronie Leo PISKE Beneficencia Portuguesa de sao Paulo
Sao Paulo, Brazil
3
8:00-12:40 MORNING 8:00 Welcome message - Jacques MORET, Laurent SPELLE
8:10 Presentation of the best cases submitted by attendees- “Y-stentriever” thrombectomy: dealing with a hard clot in basilar tip occlusion Lucas SCOTTA CABRAL, Brazil- Pseudo-occlusion and two exceptions to the rule Eytan RAZ, United States
8:30 Recorded Cases & Cases Discussion Brain AVM: Adult & Pediatric
10:00 Coffee break & Visit of the exhibition area
10:30 Recorded Cases & Cases Discussion Ischemic stroke and Aneurysm treatment
12:10 Industry sponsored Symposium* (See page 7)
12:40 Lunch Break
13:30-18:25 AFTERNOON
13:30 Recorded Cases focused on radial approach Aneurysm treatment
14:30 Industry sponsored Symposium* (See page 7)
15:00 Recorded Cases & Cases Discussion Aneurysm management
15:55 Coffee break & Visit of the exhibition area
16:25 Presentation of the best cases submitted by attendees- Anterior communicating artery embolization with two braided stents in “X” Elias RABAHI, Brazil- Endovascular occlusion of a complex MCA aneurysm through an ineffective Vitaly KISELEV, Russia
double barrel bypass using FD- Combined endovascular and microsurgical approach for a left opercular AVM Stephanie LENCK, France- Mechanical Thrombectomy in a patient with previously treated Stephen GUERIN, United States
giant fusiform aneurysm- Complex - Transitional basilar aneurysm treated with multiple FD’s telescoped: Boris PABON, Colombia
Staged or Single session?- Posterior circulation flow diversion & delayed hemorrhage - Autopsy findings Ansaar T. RAI, United States
17:25 Recorded Cases & Cases Discussion Dural AV Fistula & Aneurysm management
*These sessions do not offer continuing education credit
REC
REC
REC
REC
REC
90 min
100 min
60 min
55 min
60 min
FRIDAY 22 MARCH 2019EXPERT PANEL: Jacques MORET, Laurent SPELLE, Andres ARBELAEZ, Alejandro BERENSTEIN, Orlando M. DIAZ, Michel FRUDIT, Tudor G. JOVIN, Giuseppe LANZINO, Luis A. LEMME PLAGHOS, Italo LINFANTE, Vitor MENDES PEREIRA, Raul G. NOGUEIRA, Ronie Leo PISKE, Elias RABAHI
4
SATURDAY 23 MARCH 2019EXPERT PANEL: Jacques MORET, Laurent SPELLE, Andres ARBELAEZ, Alejandro BERENSTEIN, Orlando M. DIAZ, Michel FRUDIT, Tudor G. JOVIN, Giuseppe LANZINO, Luis A. LEMME PLAGHOS, Italo LINFANTE, Vitor MENDES PEREIRA, Raul G. NOGUEIRA, Ronie Leo PISKE, Elias RABAHI
8:00-12:30 MORNING
8:00 Presentation of the best cases submitted by attendees - Atypical aneurysm, atypical course, atypical treatment? Guilherme DABUS, United States- eCLIPs alternative for Intrasaccular ineligible cases Donald RICCI, Canada- Flow diversion in small vessels: how far can we go? Emanuele ORRU’, Canada
8:30 Recorded Cases & Cases Discussion Ischemic stroke and Aneurysm treatment
10:00 Coffee break & Visit of the exhibition area
10:30 Industry sponsored Symposium* (See page 7)
10:45 Recorded Cases & Cases Discussion Brain AVM & Aneurysm treatment
12:00 Industry sponsored Symposium* (See page 7)
12:30 Lunch Break
13:30-18:00 AFTERNOON
13:30 Recorded Cases & Cases Discussion Ischemic stroke & Dural AVF
15:30 Coffee break & Visit of the exhibition area
16:00 Presentation of the best cases submitted by attendees- Spinal AVF secondary to venous hypertension from pelvic AVF Charles A. RITCHIE, United States
and a proposal for modified spinal AVF classification- Endovascular treatment with flow diverter stent Marco Antonio OCHOA SOLORZANO, Mexico
of recanalized aneurysm with unexpected evolution- Endovascular bail-out after massive rupture for elective basilar tip aneurysm coiling David VOLDERS, Canada- Endovascular treatment of a ruptured vertebral artery fusiform Matthew TAON, United States
aneurysm in the setting of contralateral subclavian steal
16:40 Recorded Cases & Cases Discussion Miscellaneous
17:40 Award of the best case submitted
17:50 Closing remarks
*These sessions do not offer continuing education credit
REC
REC
REC
REC
90 min
75 min
120 min
60 min
5
LEARNING OBJECTIVESUpon completion of this activity, the learner should be able to:- Describe the indications of treatment for aneurysms, AVMs, specific AVMs such as of those of the marrow (spine and spinal cord), spinal dural AVMs; the management of complications, cerebral stroke, and also on percutaneous techniques and balance the beneficial outcomes from treatment procedures, endovascular or surgical, against the natural history of the disease.- Demonstrate the high-quality practice of interventional neuroradiology and neurosurgery in a team environment.- Review information regarding basic and clinical research in diseases, including techniques and technologies of interventional neuroradiology and neurosurgery.- Explain the role of imaging in the diagnosis and management of those neurovascular disorders.
EDUCATIONAL METHODS• Lectures • Question and Answer Sessions• Recorded cases • Round Table Discussions• Audiovisual Presentations
ACCREDITATION STATEMENTIn support of improving patient care, this activity is planned and implemented by Mayo Clinic College of Medicine and Science, Live Interventional Neuroradiology & Neurosurgery Course (LINNC) and NEURI Brain Vascular Centre. Mayo Clinic College of Medicine and Science is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
CREDIT STATEMENTMayo Clinic College of Medicine and Science designates this live activity for a maximum of 14 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AMA/ROYAL COLLEGE CANADAThe American Medical Association (AMA) and the Royal College of Physicians and Surgeons of Canada (Royal College) have renewed their CME agreement. Under the new agreement, select activities approved for Royal College MOC Credits are eligible for conversion to AMA PRA Category 1 Credit™. National Specialty Societies and Simulation Programs that have been approved by the Royal College as accredited CPD providers are covered by this agreement.
UEMS/EACCME CME CREDIT RECOGNITIONThe American Medical Association (AMA) has an agreement of mutual recognition of continuing medical education (CME) credit with the European Union of Medical Specialties (UEMS). Under the terms of this agreement, renewed in 2010, the AMA will convert CME credit for live and e-learning activities certified by the European Accreditation Council for Continuing Medical Education (EACCME), the accrediting arm of the UEMS, to AMA PRA Category 1 Credit™. European physicians can earn their ECMEC®s by attending live events that have been certified for AMA PRA Category 1 Credits™.
DISCLOSURESEach faculty member, including moderators and planning committee members, in the CME activity are required tocomplete a disclosure form. A copy of the MCSCPD Faculty Disclosure Policy is available in the congress bag.
6
E-POSTERS AREA• Did you know that all best cases submitted by attendees presented on stage, are also viewable in the E-POSTERS
AREA located in the exhibition?
• In addition, come and discover 8 clinical cases selected as E-posters: - Endovascular treatment of dural sinus thrombosis.
J.J. GUTIERREZ BAÑOS, Colombia - Direct puncture and percutaneous nBCA embolization of a traumatic head and neck pseudoaneurysm.
D. VOLDERS, Canada - Distal posterior communicating artery acute occlusion treated with mechanical thrombectomy
J. KOVOOR, United States - Transvenous embolization of a ruptured thalamic AVM.
S. LENCK, France - Staged X Stenting for a large ruptured Acom Aneurysm.
S. LENCK, France - One patient, two endovascular techniques and three treated intracranial aneurysms in one session.
G. SAAL, Perú - Giant MCA Aneurysm treated with FD: the importance of Windkessel Effect.
B.PABÓN, Colombia - A Subarachoid Hemorrhage Before Christmas.
V.M. PEREIRA, Canada
INDUSTRY SPONSORED SYMPOSIA
FRIDAY 22 MARCH 2019
12:10 - 12:40 - Industry sponsored Symposium - MicroVention
Evolving treatment of wide neck bifurcation aneurysms. Ansaar T. RAI, United States
14:30 - 15:00 - Industry sponsored Symposium - Medtronic
Objectives: data spotlight on safety and efficacy of Pipeline in small and medium ICA aneurysms from the PREMIER trial
- Breaking Data- PREMIER Trial Results on Pipeline in Small and Medium Aneurysms. Ricardo A. HANEL, United States
SATURDAY 23 MARCH 2019
10:30 - 10:45 - Industry sponsored Symposium - Cerenovus
PULSERIDER the Houston Experience. Orlando M. DIAZ, United States
12:00 - 12:30 - Industry sponsored Symposium - Stryker
Committed to Next Gen Innovation.
- Next generation aspiration with AXS Vecta 74. Sudhakar SATTI, United States
- Surpass Flow Diverter: A retrospective experience of 248 patients treated with 1 year follow up. Shahran DERAKHSHANI, United kingdom
7
Ingest more.
Redefine aspiration.
AXS Vecta™ 74Aspiration Catheter
The AXS Vecta 74 Aspiration Catheter is the fi rst
extra-large bore aspiration catheter on the market,
providing a 0.074in lumen designed to ingest the clot.
Copyright © 2019 StrykerAP002436 v1.0
SNV-2978 AXS Vecta 74 Corp Ad_M3a.indd 1 2/22/19 12:35 PM
Ingest more.
Redefine aspiration.
AXS Vecta™ 74Aspiration Catheter
The AXS Vecta 74 Aspiration Catheter is the fi rst
extra-large bore aspiration catheter on the market,
providing a 0.074in lumen designed to ingest the clot.
Copyright © 2019 StrykerAP002436 v1.0
SNV-2978 AXS Vecta 74 Corp Ad_M3a.indd 1 2/22/19 12:35 PM
AXS Vecta™ Aspiration Catheter RX ONLYCaution: Federal Law (USA) restricts this device to sale by or on the order of a physician.See package insert for complete indications, contraindications, warnings and instructions for use.INTENDED USE/INDICATIONS FOR USEThe AXS Vecta Aspiration System, including the AXS Vecta Aspiration Catheter, Aspiration Tubing Set, and VC-701 Cliq Aspirator Pump, is indicated in the revascularization of patients with acute ischemic stroke secondary to intracranial large vessel occlusive disease (within the internal carotid, middle cerebral – M1 and M2 segments, basilar, and vertebral arteries) within 8 hours of symptom onset. Patients who are ineligible for intravenous tissue plasminogen activator (IV t-PA) or who failed IV t-PA therapy are candidates for treatment.DEVICE DESCRIPTIONThe AXS Vecta Aspiration System consist of the AXS Vecta Aspiration Catheter, the Aspiration Tubing Set, and the VC-701 Cliq Aspirator Pump.The AXS Vecta Aspiration Catheter is a single lumen, flexible, variable stiffness catheter. It has a radiopaque marker band on the distal end and a Luer hub at the proximal end. The AXS Vecta Aspiration Catheter shaft has a lubricious hydrophilic coating at the distal end (distal 25 cm) to reduce friction during use. The Scout Introducer may be used in conjunction with the AXS Vecta Aspiration Catheter to facilitate in the introduction of the AXS Vecta Aspiration Catheter into distal vasculature and aid in navigation to distal anatomy. The Scout Introducer has a lubricious hydrophilic coating at the distal end to reduce friction during use. The inner lumen of the AXS Vecta Aspiration Catheters is compatible with the Scout Introducer, guide wires and micro catheters. The inner lumen of the Scout Introducer is compatible with guide wires and micro catheters of an outer diameter of less than 0.044in.Each package includes one AXS Vecta Aspiration Catheter, one Scout Introducer, one hemostasis valve, and two peel-away introducers. Dimensions of the AXS Vecta Aspiration Catheter and Scout Introducer are included on the individual device label. The AXS Vecta Aspiration Catheters are available in 3 different lengths, the device configurations including the length of the Scout packaged with each catheter and the recommended Microcatheter length is presented in the table 1.0 below.
Catheter part number
INC-11129 -115
INC-11129 -125
INC-11129 -132
INC-11597 -115
INC-11597 -125
INC-11597 -132
Catheter inner diameter (in) 0.071 0.071 0.071 0.074 0.074 0.074
Distal catheter outer diameter (in)
0.082 0.082 0.082 0.083 0.083 0.083
Catheter working length (cm)
115 125 132 115 125 132
Scout Introducer length (cm)
133 143 150 133 143 150
Recommended compatible microcatheter length (cm)
150 160 160 150 160 160
Recommended compatible microcatheter outer diameter (in)
0.044 max
0.044 max
0.044 max
0.044 max
0.044 max
0.044 max
Recommended compatible guidewire outer diameter (in)
0.038 max
0.038 max
0.038 max
0.038 max
0.038 max
0.038 max
The AXS Vecta Aspiration System is recommended for use in the following vessel size ranges based on non-clinical testing. Refer to Table 2.0 below.
AXS Vecta Aspiration Catheter
Catheter part number
Vessel size in mm (Vessel size in inches)
AXS Vecta 71INC-11129-115 2.1-4mm (0.083in – 0.157in)INC-11129-125 2.1-4 mm (0.083in – 0.157in)INC-11129-132 2.1-4 mm (0.083in – 0.157in)
AXS Vecta 74INC-11597-115 2.2-4 mm (0.087in – 0.157in)INC-11597-125 2.2-4 mm (0.087in – 0.157in)INC-11597-132 2.2-4 mm (0.087in – 0.157in)
CONTRAINDICATIONSThe AXS Vecta Aspiration Catheter has not been evaluated for use in the coronary vasculature. Do not use automated high-pressure contrast injection equipment with the AXS Vecta Aspiration Catheter because it may damage the device.ADVERSE EVENTS• Acute vessel occlusion• Air embolism• Allergic reaction and anaphylaxis from contrast media• Arteriovenous fistula• Death• Device malfunction• Distal embolization• Emboli• False aneurysm formation • Hematoma or hemorrhage at the puncture site• Inability to completely remove thrombus• Infection• Intracranial hemorrhage• Ischemia• Kidney damage from contrast media• Neurological deficit including stroke • Risks associated with angiographic and fluoroscopic
radiation including but not limited to: alopecia, burns ranging in severity from skin reddening to ulcers, cataracts, and delayed neoplasia
• Sterile inflammation or granulomas at the access site• Tissue necrosis• Vessel spasm, thrombosis, dissection or perforation WARNINGContents supplied STERILE using an ethylene oxide (EO) process. Do not use if sterile barrier is damaged. If damage is found, call your Stryker Neurovascular representative. For single use only. Do not reuse, reprocess or resterilize. Reuse, reprocessing or resterilization may compromise the structural integrity of the device and/or lead to device fail-ure which, in turn, may result in patient injury, illness or death. Reuse, reprocessing or resterilization may also create a risk of contamination of the device and/or cause patient infection or cross-infection, including, but not limited to, the transmission of infectious disease(s) from one patient to another. Contamination of the device may lead to injury, illness or death of the patient. After use, dispose of product and packaging in accordance with hospital, administrative and/or local government policy.WARNINGS1. The AXS Vecta Aspiration Catheter has not been evaluated
for more than one (1) clot retrieval attempt.2. The AXS Vecta Aspiration Catheter was evaluated for an
average duration of direct aspiration of 4 minutes.3. This product is intended for single use only, do not re-
sterilize or reuse. Re-sterilization and/or reuse may result in cross contamination and/or reduced performance.
4. When the catheter is exposed to the vascular system, it should be manipulated while under high-quality fluoroscopic observation. Do not advance or retract the catheter if resistance is met during manipulation; determine the cause of the resistance before proceeding.
5. Operators should take all necessary precautions to limit X-Radiation doses to patients and themselves by using sufficient shielding, reducing fluoroscopy times, and modifying X-Ray technical factors where possible.
6. This device is coated with a hydrophilic coating at the proximal end of the device for a length of 25 cm. Please refer to the Device Preparation Section for further information on how to prepare and use this device to ensure it performs as intended. Failure to abide by the warnings in this labeling might result in damage to the device coating, which may necessitate intervention or result in serious adverse events.
PRECAUTIONS1. Store in a cool, dry, dark place.2. Do not use kinked, damaged, or opened devices.3. Use the device prior to the “Use By” date specified on
the package.4. Exposure to temperatures above 54°C (130°F) may damage
device. Do not autoclave.5. Torqueing or moving the device against resistance may
result in damage to the vessel or device.6. Maintain a constant infusion of appropriate flush solution.7. If flow through the device becomes restricted, do not
attempt to clear the lumen by infusion. Remove and replace the device.
8. Examine the device to verify functionality and to ensure that its size and shape are suitable for the specific procedure for which it is to be used.
9. The AXS Vecta Aspiration Catheter should be used only by physicians trained in percutaneous procedures and/or interventional techniques.
10. The Scout Introducer should be used with a guidewire and microcatheter inserted when in vasculature.
11. If using the AXS Vecta Aspiration Catheter for thrombectomy, monitor the canister fluid level and replace the canister if the fill level reaches 75% of the canister volume
12. Administration of anticoagulants and antiplatelets should be suspended until 24 hours post-treatment. Medical management and acute post stroke care should follow the ASA guidelines.
13. Any neurological determination should be evaluated by urgent CT scan and other evaluations as indicated according to investigator/hospital best practice.
14. As in all surgical interventions, monitoring of intra-procedural blood loss is recommended so that appropriate management may be instituted.
15. Limit the usage of the AXS Vecta Aspiration Catheter to arteries greater than the catheter’s outer diameter.
16. Excessive aspiration with the distal tip of the AXS Vecta Aspiration Catheter covered by the vessel wall may cause vessel injury. Carefully investigate location of the distal tip under fluoroscopy prior to aspiration.
17. There is an inherent risk with the use of angiography and fluoroscopy.
18. When transporting the VC-701 Cliq pump, utilize the pump handle.
Copyright © 2019 Stryker AP002436 v1.0
Stryker Neurovascular47900 Bayside ParkwayFremont, CA 94538
strykerneurovascular.com
Date of Release: FEB/2019
EX_EN_US
SNV-2978 AXS Vecta 74 Corp Ad_M3a.indd 2 2/22/19 12:35 PM
Toronto Paris
NewDehli
Beijing
Santiagode Chile
Live Interventional Neuroradiology, Neurology & Neurosurgery Course
SAVE THE DATE
JUNE 3 - 5, 2019P A R I S - F R A N C Ec a r r o u s e l d u l o u v r e
www.linnc.com
Laurent SPELLE
COURSE DIRECTORS
LIVE CENTERS
Jacques MORET
HDprint_UC201907943EN_PREMIERads_SizedA5forLINNC_WithBleedsAndCrops.pdf 1 2/15/19 12:27 PM
HDprint_UC201907943EN_PREMIERads_SizedA5forLINNC_WithBleedsAndCrops.pdf 2 2/15/19 12:27 PM
GRANADA BALLROOMConference Room
ALHAMBRA BALLROOM
LOBBYWelcome Desk
MARBELLA ROOM*
MAIN BUILDINGEntrance Hotel
COURTYARD
COURTYARD
COU
RTYARD
COU
RTYA
RD
1
2 3
Exhibit Spaces
Lunch & Co�ee Break Area
4 5
6
7
ELEVATORS
E-POSTERSAREA
EXHIBITION FLOOR PLAN
WE THANK OUR PARTNERS FOR THEIR SUPPORT
Platinum sponsorsMEDTRONIC with an Educational Grant
MICROVENTION with an Educational Grant
Gold sponsorCERENOVUS with an Educational Grant
STRYKER with an Educational Grant
Exhibitors
7 BALT
5 BIOMODEX
3 CERENOVUS
1 MICROVENTION
4 PHILIPS
2 SIM&CURE
6 STRYKER
15
Marbella Room* Demonstration / Meeting Room - MICROVENTION