Annual Scientific Meeting of the American Society of Interventional and Therapeutic Neuroradiology and the Joint Section of Cerebrovascular Neurosurgery Highlights, Kona, Hawaii, February 2001

Randall T. Higashida; Tom Tomsick

The Fourth Annual Joint Meeting of the American Society of Interventional and Therapeutic Neuroradiology in conjunction with the Joint Section of Cerebrovascular Neurosurgery was held on February 9–12, 2001 in Kona, Hawaii. This year, an invitation for participation was also extended to the Japanese Society of Surgery for Cerebral Stroke and the Japanese Society of Intravascular Neurosurgery.

There were over 1100 registered participants, including more than 750 physicians, with 150 from Japan and Korea, who attended this 3½-day scientific symposium. Two special symposium sessions were held including 1-day workshops entitled Extracranial Carotid Reconstruction: Endarterectomy, Angioplasty, and Stenting and Critical Care of Neurosurgical and Endovascular Patients. There were four additional special scientific sessions: 1) Contemporary Management of Arteriovenous Malformations, 2) Management of Intracranial Aneurysms, 3) Subarachnoid Hemorrhage, and 4) Cerebral Ischemia. In addition, there were 20 luncheon seminars that included topics on revascularization techniques in acute cerebral ischemia, treatment of Moya-Moya disease, dural arteriovenous malformations, pediatric arteriovenous malformations, spinal arteriovenous malformations, and consultation with experts on complex vascular disorders.

Over 535 scientific abstracts were received, and more than 400 scientific oral and poster exhibits were presented. This meeting again displayed the true congenial collaboration between the neurosurgical and neurointerventional societies. Over the past 4 years, a relationship has been established between both societies that has led to a mutual trust and respect for the procedures, techniques, and results of therapy that contrast traditional neurosurgery and neurointerventional surgical treatment of these complex cerebrovascular disorders.

This collaboration has led to a meeting that has grown from 125 attendees 7 years ago, when the first meeting of the Cerebrovascular Neurosurgery Society convened, to the preeminent annual scientific meeting for learning about the rapid advances in the treatment and diagnosis of stroke and cerebrovascular disorders. Jacques Dion, Tom Tomsick, and Randall Higashida represented the Organizing Committee for the American Society of Interventional and Therapeutic Neuroradiology (ASITN). Joshua Bederson, Issam Awad, Robert Harbaugh, and Joel MacDonald represented the Joint Section of Cerebrovascular Neurosurgery.

Highlights of the meeting included Alex Berenstein's and Tom Tomsick's state-of-the art lectures on the endovascular management of cerebral arteriovenous malformations discussing newer techniques and embolic agents for treating adult and pediatric complex vascular lesions, including the ability to cure some of these lesions with liquid embolic adhesives. Christopher Dowd and Fernando Vinuela gave excellent presentations on interventional treatment of cerebral aneurysms, contrasting surgical versus endovascular techniques and comparing overall patient outcomes, cost, and quality-of-life issues, in addition to discussing some of the newer ongoing research studies with coated coils and stents and drug delivery systems.

Joe Eskridge and Jacques Dion presented on the endovascular management of acute subarachnoid hemorrhage by balloon angioplasty and intraarterial papavarine injection directly into vasospastic blood vessels. Randall Higashida gave an excellent overview of the current endovascular management of acute ischemic stroke by means of intraarterial thrombolysis techniques and extracranial and intracranial angioplasty and stenting for symptomatic atherosclerotic lesions.

The Lussenhop lecture was given by Professor Kazuo Hashi, entitled Epidemiological Survey of Cerebral Aneurysms and the Risk of Subarachnoid Hemorrhage. Many Japanese neurosurgeons also presented excellent results from both surgery and endovascular treatment of aneurysms, arteriovenous malformations, and ischemic stroke from their centers, and showed videotaped sessions of newer therapeutic and imaging techniques for cerebral vascular disorders.

Presidential addresses were given by Issam Awad for the Joint Section of Cerebrovascular Surgery, Nobuo Hashimoto for the Japanese Society of Surgery for Cerebral Stroke, and Akira Takahashi for the Japanese Society of Intravascular Neurosurgery. Tom Tomsick gave the ASITN presidential address. Dr. Tomsick presented highlights of the past year's accomplishments and activities of the ASITN. These included plans for the establishment of the ASITN Foundation, with pledges from industry of over $1,000,000 over 5 years by leading corporate sponsorship from Target Therapeutics and Cordis Neurovascular; establishment of 25 additional neurointerventional fellowship positions by Target Therapeutics/Boston Scientific over the next 5 years; consideration of a name change from the ASITN to the Society of Neurointerventional Surgery; consideration for establishing a stand-alone society journal; passage of Endovascular Surgical Neuroradiology Training Standards by the ACGME; development of the ASITN Web Site, which is now on-line at “www.asitn.org”; submission of “Standards of Practice Guidelines for Diagnostic and Therapeutic Neurointerventional Procedures” to the AJNR for publication; publication of a statement and editorial on acute stroke intervention (AJNR 2001; 22:54–58); sponsorship of the INSTOR Cerebral Thrombolysis Stroke Registy, established by Buddy Connors. In addition, a very successful recruitment drive led by Robert Tarr has now increased membership to over 410 physicians in the ASITN.

In addition to the intense all-day sessions, which began at 7:00 AM and lasted until 5:00 PM, there were also well-planned social activities. For those who had extra time, there was snorkeling, sailing, boating, fishing, hiking, golf, tennis, and scenic helicopter rides. An international reception was held one night, and two special Hawaiian luaus hosted by Target Therapeutics and Cordis Neurovascular were also very well attended by most of the neurointerventional physicians attending the meeting.

In summary, the collegial and congenial relationship that has now been established between the neurointerventional community and the vascular Neurosurgery Societies is now well established. This meeting has quickly become the preeminent scientific meeting for both the endovascular and neurosurgical community in cerebrovascular diseases in North America. By extending an invitation to our colleagues around the globe, it may soon evolve into the preeminent world conference of its kind.