Microcatheter embolisations - special focus: particle embolisation

Target groups: Interventional Radiologists with basic experience in complex interventions and embolisations 

 

Maximum number of participants: 5

 

Duration: 1,5 days

 

Lecturers: 

 

  • Jens Ricke, MD
    Professor and Chairman
     
  • Maciej Pech, MD
    Professor and Head of Interventional Radiology
     
  • Max Seidensticker, MD
    associate Professor and scientific director of the DAfMT
     

Course objective: The training course is designed to train microcatheter and embolisation particle handling during vascular embolisation for various indications. Modern Interventional Radiology has become excessively demanding with an increasing need for the use of advanced microcatheter and embolisation techniques in a broad range of indications from acute bleeding in emergency cases via chemoembolisation of complex malignancies to gyneacologic embolic management of uterine fibroids. The training course consists of two dominant parts: first, an interactive teaching and lecturing day will provide the necessary insights into materials and techniques available, as well as evidence, indications, patient management and challenging cases. With this theoretical fundament, the second day will take place in the large animal lab providing each participant with the opportunity to practically train microcatheter and embolisation techniques from particles to liquid glue. 

 

Day 1 - interactive lectures (3pm – 6.30pm)
Basics, theory and materials (45 min)

  • Catheters: coaxial technique, microcatheters
  • Embolisation:
    • particles  
    • coils, plugs
    • liquid glue

Transarterial chemoembolisation (45 min)

  • Basics: guidelines, evidence, indications
  • Materials:  
    • chemotherapeutics and tumor biology
    • drug-eluting beads
  • Application technique: 
    • selective vs. unselective chemoembolisation
    • visceral collaterals
  • Pros und Cons:    
    • tipps & tricks
    • challenging case discussions
    • complication management
    • clinical patient management
    • follow up

Fibroid embolisation (30 min)

  • Basics: guidelines, evidence, indications
  • Materials:    
    • catheters, particle embolisation
    • embolisation endpoint
  • Application technique: 
    • selective catheterisation and pelvic vascular anatomy
    • ovarian and other anastomoses
    • visceral collaterals
  • Pros and Cons:
    • tipps & tricks
    • pain management
    • challenging case discussions
    • complication management
    • clinical patient management
    • follow up

Gastrointestinal Bleeding (60 min)

Acute upper GI bleeding: 

  • causes and incidences
  • acute clincial management and pathways
  • risk stratification
  • endoscopic treatment: what the endoscopist can do 
  • endovascular treatment: 
    • what the IR can do
    • vascular anatomy of the upper GI tract
    • portal hypertension and management
    • embolisation strategies
    • tipps & tricks
    • challenging case discussions

Lower GI bleeding:

  • causes and incidences
  • acute clincial management and pathways
  • risk stratification
  • role of colonoscopy and push endoscopy
  • role of CT-angiography and blood pool scintigraphy
  • endovascular treatment: 
    • what the IR can do
    • vascular anatomy of the lower GI tract
    • embolisation strategies
    • tipps & tricks
    • challenging case discussions

Day 2 – Hands on (9am – 3:00pm) 

Large animal model

  • demonstration of tools and materials
  • practical training of microcatheter handling
  • practical training of particle handling
    • bleeding embolisation with particles
    • how to determine the embolisation endpoint: 
    • stepwise embolisation with different particle sizes
    • protective embolisation of collaterals with coils
    • scaffold-Technique, anchor-technique
    • embolisation with glue (histoacryl)

 

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