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Randall T. Higashida - One of the best experts on this subject based on the ideXlab platform.
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program requirements for residency fellowship education in neuroendovascular surgery Interventional Neuroradiology a special report on graduate medical education
American Journal of Neuroradiology, 2000Co-Authors: Randall T. Higashida, Van V Halbach, L N Hopkins, Alejandro Berenstein, C KerberAbstract:BACKGROUND AND PURPOSE: Neuroendovascular surgery/Interventional Neuroradiology is a relatively new subspecialty that has been evolving since the mid-1970s. During the past 2 decades, significant advances have been made in this field of minimally invasive therapy for the treatment of intracranial cerebral aneurysms; acute stroke therapy intervention; cerebral arteriovenous malformations; carotid cavernous sinus fistulas; head, neck, and spinal cord vascular lesions; and other complex cerebrovascular diseases. Advanced postresidency fellowship programs have now been established in North America, Europe, and Japan, specifically for training in this new subspecialty. METHODS: From 1986 to the present, an ad hoc committee of senior executive committee members from the American Society of Interventional and Therapeutic Neuroradiology, the Joint Section of Cerebrovascular Neurosurgery, and the American Society of Neuroradiology met to establish, by consensus, general guidelines for training physicians in this field. RESULTS: In April 1999, the Executive Committee of the Joint Section of Cerebrovascular Neurosurgery voted unanimously to endorse these training standard guidelines. In May 1999, the Executive Committee of the American Society of Interventional and Therapeutic Neuroradiology and the American Society of Neuroradiology also unanimously voted to endorse these guidelines. In June 1999, the Executive Council of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons unanimously voted to endorse these guidelines. CONCLUSION: The following guidelines for residency/fellowship education have now been endorsed by the parent organization of both the Interventional and diagnostic Neuroradiology community, as well as both senior organizations representing neurosurgery in North America. These guidelines for training should be used as a reference and guide to any institution establishing a training program in neuroendovascular surgery/Interventional Neuroradiology.
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evolution of a new multidisciplinary subspecialty Interventional Neuroradiology neuroendovascular surgery
American Journal of Neuroradiology, 2000Co-Authors: Randall T. HigashidaAbstract:The field of Interventional Neuroradiology was developed originally in the early 1960s when Lussenhop, a neurosurgeon, described the technique of intravascular embolization of brain arteriovenous malformations by injecting silastic beads directly into the arteries of the neck for occlusion [(1)][1
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Evolution of a new multidisciplinary subspecialty: Interventional Neuroradiology/neuroendovascular surgery.
American Journal of Neuroradiology, 2000Co-Authors: Randall T. HigashidaAbstract:The field of Interventional Neuroradiology was developed originally in the early 1960s when Lussenhop, a neurosurgeon, described the technique of intravascular embolization of brain arteriovenous malformations by injecting silastic beads directly into the arteries of the neck for occlusion [(1)][1
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Program requirements for residency/fellowship education in neuroendovascular surgery/Interventional Neuroradiology: a special report on graduate medical education.
American Journal of Neuroradiology, 2000Co-Authors: Randall T. Higashida, L N Hopkins, Alejandro Berenstein, Van V. Halbach, Kerber CAbstract:BACKGROUND AND PURPOSE: Neuroendovascular surgery/Interventional Neuroradiology is a relatively new subspecialty that has been evolving since the mid-1970s. During the past 2 decades, significant advances have been made in this field of minimally invasive therapy for the treatment of intracranial cerebral aneurysms; acute stroke therapy intervention; cerebral arteriovenous malformations; carotid cavernous sinus fistulas; head, neck, and spinal cord vascular lesions; and other complex cerebrovascular diseases. Advanced postresidency fellowship programs have now been established in North America, Europe, and Japan, specifically for training in this new subspecialty. METHODS: From 1986 to the present, an ad hoc committee of senior executive committee members from the American Society of Interventional and Therapeutic Neuroradiology, the Joint Section of Cerebrovascular Neurosurgery, and the American Society of Neuroradiology met to establish, by consensus, general guidelines for training physicians in this field. RESULTS: In April 1999, the Executive Committee of the Joint Section of Cerebrovascular Neurosurgery voted unanimously to endorse these training standard guidelines. In May 1999, the Executive Committee of the American Society of Interventional and Therapeutic Neuroradiology and the American Society of Neuroradiology also unanimously voted to endorse these guidelines. In June 1999, the Executive Council of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons unanimously voted to endorse these guidelines. CONCLUSION: The following guidelines for residency/fellowship education have now been endorsed by the parent organization of both the Interventional and diagnostic Neuroradiology community, as well as both senior organizations representing neurosurgery in North America. These guidelines for training should be used as a reference and guide to any institution establishing a training program in neuroendovascular surgery/Interventional Neuroradiology.
L Lopezibor - One of the best experts on this subject based on the ideXlab platform.
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radiation doses in patient eye lenses during Interventional Neuroradiology procedures
American Journal of Neuroradiology, 2016Co-Authors: R Sanchez, E Vano, J M Fernandez, S Rosati, L LopeziborAbstract:BACKGROUND AND PURPOSE: Eye lenses are among the most sensitive organs to x-ray radiation and may be considered at risk during neuroInterventional radiology procedures. The threshold dose to produce eye lens opacities has been recently reduced to 500 mGy by the International Commission on Radiologic Protection. In this article, the authors investigated the radiation doses delivered to patients9 eyes during Interventional Neuroradiology procedures at a university hospital. MATERIALS AND METHODS: Small optically stimulated luminescence dosimeters were located over patients9 eyes during 5 diagnostic and 31 therapeutic procedures performed in a biplane x-ray system. Phantom measurements were also made to determine the level of radiation to the eye during imaging runs with conebeam CT. RESULTS: The left eye (located toward the lateral C-arm x-ray source) received a 4.5 times greater dose than the right one. The average dose during embolization in the left eye was 300 mGy, with a maximum of 2000 mGy in a single procedure. The patient who received this maximum eye dose needed 6 embolization procedures to treat his high-volume AVM. If one took into account those 6 embolizations, the eye dose could be 2-fold. Sixteen percent of the embolizations resulted in eye doses of >500 mGy. CONCLUSIONS: A relevant fraction of patients received eye doses exceeding the threshold of 500 mGy. A careful optimization of the procedures and follow-up of these patients to evaluate potential lens opacities should be considered.
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brain radiation doses to patients in an Interventional Neuroradiology laboratory
American Journal of Neuroradiology, 2014Co-Authors: R Sanchez, E Vano, J M Fernandez, M Moreu, L LopeziborAbstract:BACKGROUND AND PURPOSE: In 2011, the International Commission on Radiologic Protection established an absorbed-dose threshold to the brain of 0.5 Gy as likely to produce cerebrovascular disease. In this paper, the authors investigated the brain doses delivered to patients during clinical Neuroradiology procedures in a university hospital. MATERIALS AND METHODS: The radiation dose delivered to the brain was investigated in 99 diagnostic and therapeutic Interventional Neuroradiology procedures. Brain doses were calculated in a mathematic model of an adult standard anthropomorphic phantom by using the technical and radiation dose data of an x-ray biplane system submitted to regular quality controls and calibration programs. RESULTS: For cerebral embolizations, brain doses resulted in a maximum value of 1.7 Gy, with an average value of 500 mGy. Median and third quartile resulted in 400 and 856 mGy, respectively. For cerebral angiography, the average dose in the brain was 100 mGy. CONCLUSIONS: This work supports the International Commission on Radiologic Protection recommendation on enhancing optimization when doses to the brain could be higher than 0.5 Gy. Radiation doses should be recorded for all patients and kept as low as reasonably achievable. For pediatric patients and young adults, an individual evaluation of brain doses could be appropriate.
C Kerber - One of the best experts on this subject based on the ideXlab platform.
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program requirements for residency fellowship education in neuroendovascular surgery Interventional Neuroradiology a special report on graduate medical education
American Journal of Neuroradiology, 2000Co-Authors: Randall T. Higashida, Van V Halbach, L N Hopkins, Alejandro Berenstein, C KerberAbstract:BACKGROUND AND PURPOSE: Neuroendovascular surgery/Interventional Neuroradiology is a relatively new subspecialty that has been evolving since the mid-1970s. During the past 2 decades, significant advances have been made in this field of minimally invasive therapy for the treatment of intracranial cerebral aneurysms; acute stroke therapy intervention; cerebral arteriovenous malformations; carotid cavernous sinus fistulas; head, neck, and spinal cord vascular lesions; and other complex cerebrovascular diseases. Advanced postresidency fellowship programs have now been established in North America, Europe, and Japan, specifically for training in this new subspecialty. METHODS: From 1986 to the present, an ad hoc committee of senior executive committee members from the American Society of Interventional and Therapeutic Neuroradiology, the Joint Section of Cerebrovascular Neurosurgery, and the American Society of Neuroradiology met to establish, by consensus, general guidelines for training physicians in this field. RESULTS: In April 1999, the Executive Committee of the Joint Section of Cerebrovascular Neurosurgery voted unanimously to endorse these training standard guidelines. In May 1999, the Executive Committee of the American Society of Interventional and Therapeutic Neuroradiology and the American Society of Neuroradiology also unanimously voted to endorse these guidelines. In June 1999, the Executive Council of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons unanimously voted to endorse these guidelines. CONCLUSION: The following guidelines for residency/fellowship education have now been endorsed by the parent organization of both the Interventional and diagnostic Neuroradiology community, as well as both senior organizations representing neurosurgery in North America. These guidelines for training should be used as a reference and guide to any institution establishing a training program in neuroendovascular surgery/Interventional Neuroradiology.
Erwan Kerrien - One of the best experts on this subject based on the ideXlab platform.
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blood vessel modeling for interactive simulation of Interventional Neuroradiology procedures
Medical Image Analysis, 2017Co-Authors: Erwan Kerrien, Ahmed Yureidini, Jeremie Dequidt, Christian Duriez, R Anxionnat, Stephane CotinAbstract:Endovascular interventions can benefit from interactive simulation in their training phase but also during pre-operative and intra-operative phases if simulation scenarios are based on patient data. A key feature in this context is the ability to extract, from patient images, models of blood vessels that impede neither the realism nor the performance of simulation. This paper addresses both the segmentation and reconstruction of the vasculature from 3D Rotational Angiography data, and adapted to simulation: An original tracking algorithm is proposed to segment the vessel tree while filtering points extracted at the vessel surface in the vicinity of each point on the centerline; then an automatic procedure is described to reconstruct each local unstructured point set as a skeleton-based implicit surface (blobby model). The output of successively applying both algorithms is a new model of vasculature as a tree of local implicit models. The segmentation algorithm is compared with Multiple Hypothesis Testing (MHT) algorithm (Friman et al, 2010) on patient data, showing its greater ability to track blood vessels. The reconstruction algorithm is evaluated on both synthetic and patient data and demonstrates its ability to fit points with a subvoxel precision. Various tests are also reported where our model is used to simulate catheter navigation in Interventional Neuroradiology. An excellent realism, and much lower computational costs are reported when compared to triangular mesh surface models.
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AE-CAI - Time to Go Augmented in Vascular Interventional Neuroradiology
Augmented Environments for Computer-Assisted Interventions, 2012Co-Authors: René Anxionnat, Marie-odile Berger, Erwan KerrienAbstract:This editorial paper reports on our experience in introducing augmented reality (AR) in Interventional Neuroradiology environments. Our expectations about the next AR tools, in particular for more advanced visualization, are also put forward. For practical reasons, the references will be restricted to our contributions. For further information, the last recommendations concerning the medical management of aneurysm induced hemorrhages can be found in [1].
R Sanchez - One of the best experts on this subject based on the ideXlab platform.
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radiation doses in patient eye lenses during Interventional Neuroradiology procedures
American Journal of Neuroradiology, 2016Co-Authors: R Sanchez, E Vano, J M Fernandez, S Rosati, L LopeziborAbstract:BACKGROUND AND PURPOSE: Eye lenses are among the most sensitive organs to x-ray radiation and may be considered at risk during neuroInterventional radiology procedures. The threshold dose to produce eye lens opacities has been recently reduced to 500 mGy by the International Commission on Radiologic Protection. In this article, the authors investigated the radiation doses delivered to patients9 eyes during Interventional Neuroradiology procedures at a university hospital. MATERIALS AND METHODS: Small optically stimulated luminescence dosimeters were located over patients9 eyes during 5 diagnostic and 31 therapeutic procedures performed in a biplane x-ray system. Phantom measurements were also made to determine the level of radiation to the eye during imaging runs with conebeam CT. RESULTS: The left eye (located toward the lateral C-arm x-ray source) received a 4.5 times greater dose than the right one. The average dose during embolization in the left eye was 300 mGy, with a maximum of 2000 mGy in a single procedure. The patient who received this maximum eye dose needed 6 embolization procedures to treat his high-volume AVM. If one took into account those 6 embolizations, the eye dose could be 2-fold. Sixteen percent of the embolizations resulted in eye doses of >500 mGy. CONCLUSIONS: A relevant fraction of patients received eye doses exceeding the threshold of 500 mGy. A careful optimization of the procedures and follow-up of these patients to evaluate potential lens opacities should be considered.
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brain radiation doses to patients in an Interventional Neuroradiology laboratory
American Journal of Neuroradiology, 2014Co-Authors: R Sanchez, E Vano, J M Fernandez, M Moreu, L LopeziborAbstract:BACKGROUND AND PURPOSE: In 2011, the International Commission on Radiologic Protection established an absorbed-dose threshold to the brain of 0.5 Gy as likely to produce cerebrovascular disease. In this paper, the authors investigated the brain doses delivered to patients during clinical Neuroradiology procedures in a university hospital. MATERIALS AND METHODS: The radiation dose delivered to the brain was investigated in 99 diagnostic and therapeutic Interventional Neuroradiology procedures. Brain doses were calculated in a mathematic model of an adult standard anthropomorphic phantom by using the technical and radiation dose data of an x-ray biplane system submitted to regular quality controls and calibration programs. RESULTS: For cerebral embolizations, brain doses resulted in a maximum value of 1.7 Gy, with an average value of 500 mGy. Median and third quartile resulted in 400 and 856 mGy, respectively. For cerebral angiography, the average dose in the brain was 100 mGy. CONCLUSIONS: This work supports the International Commission on Radiologic Protection recommendation on enhancing optimization when doses to the brain could be higher than 0.5 Gy. Radiation doses should be recorded for all patients and kept as low as reasonably achievable. For pediatric patients and young adults, an individual evaluation of brain doses could be appropriate.
