Description & Objectives
This symposium is intended for neurologists, neurosurgeons, neuroradiologists, vascular surgeons, emergency physicians, nurse practitioners, physician assistants, nurses and allied health professionals who are closely involved in the management of patients with cerebrovascular disease and have a specific focus on comprehensive stroke in WA, AK, ID, MT, OR and CA.
Healthcare providers today are faced with a rapidly growing population of patients with both acute and chronic cerebrovascular disease. Stroke is the fourth leading cause of death in the United States. Each year, approximately 795,000 people experience a new or recurrent stroke in the United States. On average, one American dies from stroke every four minutes. Clinicians may not be aware of all of the factors in the development of stroke and the complications of stroke presentation and management.
Cerebrovascular disease and stroke management is complex and requires ongoing education for neurologists, neurosurgeons and other sub-specialists who work with these patients. There are several conditions associated with cerebrovascular disease and stroke. Aortic aneurysms were the primary cause of 10,597 deaths and a contributing cause in more than 17,215 deaths in the United States in 2009. A ruptured aneurysm in the brain can cause a stroke. When a patient suffers a stroke, treatment must begin immediately. With the rapid advancements in technology and treatment modalities, clinicians and hospitals need to quickly adapt their practices. Practitioners are faced with a magnitude of choices for detecting and treating stroke and cerebrovascular disease and have expressed a need to be more informed on how to select the best option for their patients.
At the conclusion of this symposium, the participant will provide better patient care through an increased ability to:
- Describe current indications for systemic thrombolytic therapy for ischemic stroke, outline limitations of systemic thrombolysis for severe stroke and review ways of experimental augmentation of tPA therapy
- Discuss intracranial aneurysm symptoms, review aneurysm treatment and describe long term follow up of aneurysms
- Describe the significance of carotid stenosis, determine the need for carotid treatment and review the follow up plan for carotid disease
- List and describe factors that correlate acute ischemic stroke and endovascular therapy that have a good outcome, discuss how age relates to this outcome and decide what imaging factors as useful tools for patient selection
- Review the indications for surgical intervention, describe the novel surgical treatments of ICH and discuss potential future surgical treatment of ICH
- Describe the mechanism of action of the newer and older anticoagulants, outline methods to reverse acute hemorrhage and define the risks and complications involved in transfusion and identity transfusion alternatives
- Outline the benefit and risk of the novel anticoagulants relative to warfarin in atrial fibrillation and review the emerging data that supports catheter-based approaches to stroke risk reduction in atrial fibrillation
- Describe indications and expected outcomes of TCD in SAH; outline indications and expected outcomes in acute stroke and review diagnostic criteria, current limitations and solutions for vasospasm
- Review the current state of evidence, including randomized, controlled trials, for the use of therapeutic hypothermia for the prevention of secondary brain injury
- Outline the major research effects on neuro-interventions, discuss the role of research in determining treatments and predict the future trends in research
- Explain the role of telemedicine in the care of stroke patients and describe the new technologies and their potential impact on treatment of cerebrovascular disease
- Discuss the latest trends in treating atrial fibrillation as it relates to stroke risk
- Describe the methods and results of the ARUBA trial and discuss the implications of the ARUBA trial on the day-to-day management of AVMs
- List the indications and outcomes for surgical vs. endovascular treatment of intracranial aneurysms and discuss the utilization of new technologies in endovascular therapy including flow diverting stents
- Discuss an evidence-based review of acute stroke imaging algorithm with a focus on controversies surrounding recently published data from "MR Rescue"
Explain the basics of imaging parameters and the clinical applications
- Review diagnostic clues to implicate aortic arch-associated cerebral infractions, identify highest risk lesions by location and morphology and explain describe research regarding anti-thrombotic medications and other secondary therapy
Discuss surgical treatment options for calcified aorta and describe the indication and methods for aortic endarterectomy
Outline basic principles of coiling aneurysms and operate the basic equipment used for coiling aneurysms
Discuss arteriovenous malformations (AVM) classifications and treatment and outline aneurysm treatment and outcomes
Apply hands-on experience in managing carotid endarterectomy with exposure and performance of operative technique
Review platforms for neuronavigation and discuss the various uses of neuronavigation
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