E-071 Organization of a Neurointerventional Fellowship Curriculum

Introduction The field of Neurointervention has attracted some of the very best physicians across the world. Given the interdisciplinary nature of this specialty, radiologists, neurosurgeons, and neurologists have been trained in this specialty. This relatively new field has brought in ground breaking changes in the ways we now treat a number of cerebrovascular disorders. However, there continues to be controversy regarding the advantages/benefits of this treatment modality for certain conditions as well as lack of evidence for other conditions. The onus is on the current fellowship training programs to use wisdom and experience in developing comprehensive fellowship training so as to produce the neurointervention leaders of tomorrow. Several significant and very basic problems currently exist with Neurointervention fellowship training, including but not limited to, the lack of an appropriate fellowship accreditation board, lack of a Neurointerventional boards exam, differences in fellowship training experience based on the educational background of Neurointerventional faculty, and lack of consensus as well as implementation of a didactic curriculum and number of cases required for graduation. The objective of this report is to present a comprehensive three -tier model for a Neurointerventional didactics program. Methods The model divides an annual Neurointerventional didactic curriculum in to three tiers: Introduction to Neurointervention Series: Basic concepts of Neurointervention. Implemented during the first two months of the academic year. Faculty/speaker driven. Total 20 sessions. See Table 1. Neurointervention Core Curriculum: Implemented during months 3 to 12 of the academic year. Faculty/speaker moderated; more interactive. Total 30 sessions. See. Table 2. Neurointervention Advanced Didactics: Periodic conference sessions. See Table 3. Other aspects: Neurointerventional Fellow Progression in Angio Suite Neurointerventional fellow 360 degrees evaluation Research during Neurointerventional fellowship Abstract E-071 Table 1 Introduction to neurointervention series Didactic session Category Introduction to AngioSuite, diagnostic table set up, biplane operations Procedural Introduction to vascular access, closure devices, contrast agents, and medications Procedural Introduction to neurointervention equipment and devices Procedural Introduction to radiation safety Procedural Introduction to preparing angio reports Documentation Doctoring skills in neurointervention: Taking informed consent and other Communication Introduction to diagnostic cerebral angiography Procedural Introduction to cerebrovascular anatomy Basic science Introduction to cerebral venous anatomy Basic science Introduction to external carotid system anatomy Basic science Introduction to embryology of cerebrovascular system and congenital variants Basic science Introduction to spinal vascular embryology, anatomy, and spinal angiography Basic science and procedural Introduction to pediatric diagnostic and interventional angiography Procedural Simulator training Session I Procedural Simulator training Session II Procedural Research during neurointervention fellowship Research Key NI articles discussion Session I: stroke Evidence based medicine Key NI articles discussion Session II: aneurysms Evidence based medicine Key NI articles discussion Session III: AVMs Evidence based medicine Fellow’s review of the neurointervention introduction series NA Abstract E-071 Table 2 Neurointervention core curriculum Didactic session Category Basics of acute ischemic stroke Basic science Review of stroke intervention trials Evidence based medicine Neurointerventional techniques for stroke intervention Procedural Intracranial aneurysms Basic science Review of aneurysm trials Evidence based medicine Neurointerventional techniques for intracranial aneurysms Procedural Endovascular management of vasospasm Procedural Introduction to intracranial arteriovenous malformations Basic science Review of AVM literature Evidence based medicine Endovascular management of intracranial AVMs Procedural Dural arteriovenous fistulas and their management Basic science and procedural Carotid cavernous fistulas and their management Basic science and procedural Extracranial carotid stenting Procedural Intracranial stenting and balloon angioplasty Procedural Neurointervention for arterial dissections Procedural Embolization for tumors of head and neck Basic science and procedural Spinal vascular lesions and their management Basic science and procedural Endovascular complications and their management Procedural Vein of Galen aneurysmal malformation Basic science and procedural Other pediatric vascular disorders Basic science and procedural Provocative testing: balloon test occlusion and Wada Procedural Neurointervention for epistaxis and oropharyngeal bleeding Procedural Cerebral venous thrombosis Procedural Idiopathic intracranial hypertension Basic science and procedural Intraoperative neurophysiologic monitoring Basic science and procedural Neurointervention and anaesthesia Basic science and procedural Neurointervention considerations in pregnant patients Basic science Cost comparison of neurointervention equipment and devices Cost effective patient care Neurointervention billing and coding Documentation Setting up a neurointervention practice NA Fellow’s review of the neurointervention core curriculum NA Abstract E-071 Table 3 Neurointervention advanced didactics Monthly cerebrovascular anatomy assigned readings Basic science Monthly neurosurgery cerebrovascular conference Basic science, procedural, and QI Monthly neurointervention difficult cases review Procedural and QI Monthly Morbidity, mortality, improvement conference QI Quarterly neuroradiology conference Basic science Quarterly review of JNIS and INR journal issues Basic science, EBM, procedural Annual product line presentation series: penumbra Procedural Annual product line presentation series: EV3 Procedural Annual product line presentation series: Codman Procedural Annual product line presentation series: Stryker Procedural Annual product line presentation series: Microvention Procedural Disclosures A. Garg: None.