E-071 Organization of a Neurointerventional Fellowship Curriculum
Authors: Garg A 
Published: July 2014

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 sessionCategoryIntroduction to AngioSuite, diagnostic table set up, biplane operationsProceduralIntroduction to vascular access, closure devices, contrast agents, and medicationsProceduralIntroduction to neurointervention equipment and devicesProceduralIntroduction to radiation safetyProceduralIntroduction to preparing angio reportsDocumentationDoctoring skills in neurointervention: Taking informed consent and otherCommunicationIntroduction to diagnostic cerebral angiographyProceduralIntroduction to cerebrovascular anatomyBasic scienceIntroduction to cerebral venous anatomyBasic scienceIntroduction to external carotid system anatomyBasic scienceIntroduction to embryology of cerebrovascular system and congenital variantsBasic scienceIntroduction to spinal vascular embryology, anatomy, and spinal angiographyBasic science and proceduralIntroduction to pediatric diagnostic and interventional angiographyProceduralSimulator training Session IProceduralSimulator training Session IIProceduralResearch during neurointervention fellowshipResearchKey NI articles discussion Session I: strokeEvidence based medicineKey NI articles discussion Session II: aneurysmsEvidence based medicineKey NI articles discussion Session III: AVMsEvidence based medicineFellow’s review of the neurointervention introduction seriesNAAbstract E-071 Table 2

Neurointervention core curriculum

Didactic sessionCategoryBasics of acute ischemic strokeBasic scienceReview of stroke intervention trialsEvidence based medicineNeurointerventional techniques for stroke interventionProceduralIntracranial aneurysmsBasic scienceReview of aneurysm trialsEvidence based medicineNeurointerventional techniques for intracranial aneurysmsProceduralEndovascular management of vasospasmProceduralIntroduction to intracranial arteriovenous malformationsBasic scienceReview of AVM literatureEvidence based medicineEndovascular management of intracranial AVMsProceduralDural arteriovenous fistulas and their managementBasic science and proceduralCarotid cavernous fistulas and their managementBasic science and proceduralExtracranial carotid stentingProceduralIntracranial stenting and balloon angioplastyProceduralNeurointervention for arterial dissectionsProceduralEmbolization for tumors of head and neckBasic science and proceduralSpinal vascular lesions and their managementBasic science and proceduralEndovascular complications and their managementProceduralVein of Galen aneurysmal malformationBasic science and proceduralOther pediatric vascular disordersBasic science and proceduralProvocative testing: balloon test occlusion and WadaProceduralNeurointervention for epistaxis and oropharyngeal bleedingProceduralCerebral venous thrombosisProceduralIdiopathic intracranial hypertensionBasic science and proceduralIntraoperative neurophysiologic monitoringBasic science and proceduralNeurointervention and anaesthesiaBasic science and proceduralNeurointervention considerations in pregnant patientsBasic scienceCost comparison of neurointervention equipment and devicesCost effective patient careNeurointervention billing and codingDocumentationSetting up a neurointervention practiceNAFellow’s review of the neurointervention core curriculumNAAbstract E-071 Table 3

Neurointervention advanced didactics

Monthly cerebrovascular anatomy assigned readingsBasic scienceMonthly neurosurgery cerebrovascular conferenceBasic science, procedural, and QIMonthly neurointervention difficult cases reviewProcedural and QIMonthly Morbidity, mortality, improvement conferenceQIQuarterly neuroradiology conferenceBasic scienceQuarterly review of JNIS and INR journal issuesBasic science, EBM, proceduralAnnual product line presentation series: penumbraProceduralAnnual product line presentation series: EV3ProceduralAnnual product line presentation series: CodmanProceduralAnnual product line presentation series: StrykerProceduralAnnual product line presentation series: MicroventionProcedural

Disclosures

A. Garg: None.