Through extensive online exchanges with foreign experts and colleagues, sharing advanced ideas and technical experience, jointly promote the further development of neurointerventional technology.

On October 20-24, 2021, the Oriental Conference of Interventional Neuroradiology (OCIN) 2021 is being held mainly offline, supplemented by online transmission, on the banks of the Huangpu River in Shanghai.

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On October 23, OCIN 2021 International Special Session was successfully held in the cloud. Many well-known international experts in the field of cerebrovascular diseases from the three major international academic organizations of EACoN, SNIS, and ESMINT gathered at the OCIN International Special Session to spread advanced ideas through case analysis, special lectures, academic reports, etc., and join hands to contribute an international vision for OCIN 2021 Full dialogue with Chinese experience.

EACoN-OCIN

Multi-dimensional Discussion and In-depth Exploration, New Thinking on Clinical Application of FD

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The conference was addressed by Prof. jianmin Liu and Prof. pengfei Yang from Cerebrovascular Disease Center of Shanghai Changhai Hospital, Prof. KenjiSugiu from okayama university and Prof. Sang Hyun SUH from Korean society of neurointerventionism. The professors looked forward to more in-depth exchanges and cooperation among China, Japan and the rok in the field of cerebrovascular disease, and look forward to the next OCIN and EACon reunion.

• Shinichi Yoshimura from Hyogo College of Medicine  shared the experience of the technical difficulties of mechanical thrombus removal . Through case sharing, he explained in detail the endovascular treatment techniques used in the department of large thrombus load: 1. Proximal balloon plus stent removal or thrombus removal Aspiration; 2. Contralateral retrograde angiography; 3. Parallel stent removal technique; 4. Thrombus reduction under the stent retractor. Later, the clinical study of embolization removal for distal arterial occlusion was interpreted, and it was believed that for distal arterial thrombosis, a small stent combined with a suction catheter is a better choice, and intra-arterial urokinase can be used as the second choice when embolization is not possible.
• Professor Yukiko Enomoto from Gifu University Graduate School of Medicine analyzed the data from the clinical study of mechanical thrombectomy in Japan, and proposed that the operation time is closely related to the clinical prognosis of patients, and that the poor clinical prognosis of some patients is related to the failure of surgical approach selection, and shared Decision-making strategy for choosing surgical approach.
• Professor Byung Moon Kim from Yonsei University College of Medicine, through the interpretation of ICAS-LVO related research, proposed that ICAS-LVO may undergo immediate or delayed reocclusion after mechanical thrombectomy. Therefore, ICAS-LVO was identified early and adopted Remedial strategies such as glycoprotein infusion or stent-plasty are of great significance for the early recanalization of ICAS-LVO and the improvement of long-term prognosis.
• Professor Jin Soo Lee from Ajou University Medical Center shared the results of two recent clinical RCT studies BEST and BASICS on posterior circulatory occlusion. He proposed that the factors affecting the prognosis of posterior circulatory occlusion include basic infarct volume, vascular recanalization time, and potential For atherosclerosis and contralateral blood flow, suction technology can be used for occlusion of the top vessel, and stent removal technology can be used for vascular trunk occlusion.
• Professor Xiaochuan Huo from the Neurological Intervention Center of Beijing Tiantan Hospital shared the diagnosis and treatment of posterior circulation tandem lesions and bilateral posterior circulation lesions, and carefully explained the surgical approach selection, treatment strategy designation and identification of the severity of lesions for special posterior circulation lesions. Experience

 

 

• Professor Nobuyuki SAKAI described many cases of recurrence after stent-assisted coil embolization of intracranial aneurysms, and proposed that blood flow guide devices are a very effective treatment strategy for these patients. However, some complications may still occur after surgery, such as far Therefore, it is necessary to carry out further experiments and postoperative evaluations to optimize the application of blood flow guide devices in aneurysms.
• Professor Hyun Seung Kang from South Korea pointed out that the blood flow guiding device has a significant effect on the treatment of posterior circulating aneurysms, and can significantly reduce the adverse events of patients with posterior communicating aneurysms. However, long-term postoperative drug treatment, including antiplatelet therapy and statin therapy It is very important, especially for antiplatelet drugs, which should be taken for at least 6 months after surgery. The professors were very concerned about the use of antiplatelet drugs after the operation, and they described the center's plan one after another. The "brainstorming" in the live broadcast room became more and more intense.
• Professor Hyun Seung Kang from South Korea pointed out that the blood flow guiding device has a significant effect on the treatment of posterior circulating aneurysms, and can significantly reduce the adverse events of patients with posterior communicating aneurysms. However, long-term postoperative drug treatment, including antiplatelet therapy and statin therapy It is very important, especially for antiplatelet drugs, which should be taken for at least 6 months after surgery. The professors were very concerned about the use of antiplatelet drugs after the operation, and they described the center's plan one after another. The "brainstorming" in the live broadcast room became more and more intense.
• Professor Deok Hee Lee, also from South Korea, analyzed the image characteristics of the blood flow guide before and after the treatment of aneurysm from an imaging point of view. Professor Lee said that although DSA is still the gold standard for endovascular treatment and examination, we cannot ignore the role of CTA and MRA, especially in the long-term follow-up process after surgery. For the postoperative follow-up, Professor Lee believes that it should be optimized based on the patient's past medical history and diseased blood vessels. Early follow-up can use CTA to reduce renal damage. Professor Lee also showed the results of CTA and MRA re-examinations after the implantation of the blood flow guiding device in patients with aneurysm. It seems that these two can replace DSA to a large extent. Professor Lee's speech gave us new thinking about the postoperative follow-up strategy.
• Professor Lu Nan of Changhai Hospital analyzed 28 patients with intracranial aneurysms beyond the circle of Willis treated with blood flow guiding devices from April 2018 to December 2020. For the long-term prognosis, only 1 patient had permanent disability. /die.

This proves that the blood flow guide device has a good effect on the treatment of patients with intracranial aneurysms beyond the circle of Willis. However, there are also some problems in practice, such as delayed occlusion in the blood flow guide device and occlusion of the branch vessels of the aneurysm. Ischemia, etc., which requires us to have adequate antiplatelet treatment before using the blood flow guiding device. Regular, long-term, and adequate antiplatelet therapy can effectively reduce complications without increasing the risk of bleeding.

Finally, Professor Chen Zhen from the First Affiliated Hospital of Zhengzhou University reported on the treatment of ruptured intracranial aneurysms with blood flow guiding devices. Professor Chen believes that blood flow guiding devices can significantly reduce the risk of aneurysm rupture. However, there are still controversies about the circulatory rupture aneurysm after the blood flow steering device is treated. The large-scale clinical research on the blood flow steering device is still necessary. The discussion has to be stopped in the passage of time. However, the enthusiasm of the professors has not diminished at all, I believe This exchange will definitely open up new directions for the application of blood flow guiding devices.

ESMINT-OCIN

Talk about the Frontier from a Clinical Standpoint, Detail New Advances in AVM

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At the OCIN-ESMINT joint meeting on the afternoon of October 23, experts from Europe shared their valuable experience.

• ESMINT Chairman Professor Jens Fiehler and OCIN chairman Professor Liu Jianmin as conference speech, Professor Jens Fiehler OCIN I wish this meeting a complete success, thanks to Professor Liu Jianmin European colleagues to share the international advanced technology and experience at the meeting.
• Professor Rene Chapot shared the latest progress of AVM embolization via venous approach. Intravenous embolization can be used as a main program for the treatment of AVM, and it has a better effect in the treatment of some deep and difficult AVMs.
• Professor Zsolt Kulcsar shared the latest progress in the treatment of chronic subdural hemorrhage by middle meningeal artery embolization. Discussed with Chinese experts on indications, image evaluation, and the best time for treatment.
• Professor Jens Fiehler discussed with everyone the question of how much evidence-based basis is needed for new neurointervention techniques, and put forward the smallest clinically important differences as a reference for designing clinical trials and changing clinical practice.
• Professor Alessandra Biondi shared the experience of treating aneurysms with intrasaccular devices, and discussed the selection of devices and bleeding risks with the experts present.
• Professor Alejandro Tonasello Weits introduced the ANGICAT randomized controlled clinical trial and discussed the main conclusions and implications for subsequent clinical studies.

SNIS-OCIN

Bring Forth the New, Insight into the New Trend of Disease Diagnosis and Treatment

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The following OCIN-SNIS joint meeting was even more exciting. OCIN Chairman Professor Jianmin Liu and SNIS Chairman Professor Michael Chen delivered speeches  for the meeting respectively, and experts from North America brought the latest developments on intracranial aneurysm intracapsular perturbation device and ischemic stroke thrombectomy, bringing new ideas to everyone.

Professor Daniel Hoit introduced the technology of the spoiler device in the aneurysm sac. Professor Mahesh Jayaraman shared his experience on optimizing the thrombus removal process. Professor Felipe Albuquerque introduced the latest developments in the Journal of Neurointerventional Surgery. Professor Eytan Raz introduced the significance of the anatomy of the middle cerebral artery M1 for thrombectomy. Professor Michael Chen explained the importance of reducing ineffective recanalization of stroke.

OCIN international channel fully reflects the international level of the Conference, through extensive online exchanges with foreign experts and colleagues, sharing advanced ideas and technical experience, jointly promote the further development of neurointerventional technology at home and abroad.