skills, at least finish 80 case of DSA before stenting ➢ 病人选择、标准化术前评诂、术中操作规程和标准 化的术后跟踪随访
2020/11/30
Contents of training
Procedure training ➢ pre-procedure evaluation ➢ Indication and contraindication ➢ risk reducing ➢ management of complications ➢ post-procedure management ➢ follow-up
(64-tier-CTA) ➢ Magnetic resonance angiography (MRA) ➢ Carotid angiography (the gold standard)
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颈动脉支架术的适应症
American Heart Association Guidelines ➢ Asymptomatic Patients ✓ For treatment of 70% or greater stenosis ✓ Perioperative stroke/death must be less than 3% ➢ Symptomatic Patients ✓ For treatment of 50% or greater stenosis ✓ Perioperative stroke/death must be less than 6% ➢ No proven indications beyond these thresholds
2020/11/30
Contents of training
Endovascular skill training
➢ Acupuncture ➢ Cerebrovascular angiography ➢ Carotid angioplasty (balloon dilation) ➢ Carotid stent implantation ➢ Angioplasty and stenting in
China
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血管神经病学:神经科新分支
2020/11/30
How to train a Neuro-endovascular specialists (recommendations from
academic societies)
The American Neurosurgery Association (ANA) When to do it
help) ➢ Clamp the aneurysm (limited to SAH)
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Do we have a searing iron ? Stent
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Why should Neurologists be trained with endovascular techniques?
➢ The future of neurology will be focused in treatment
➢ Lessens learned from cardiology ➢ Endovascular techniques will become key
issue in stroke treatment and prevention ➢ The special status of stroke management in
颅内外动脉狭窄的介入治疗
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What cannot be cured with medicaments is cured by knife, what knife cannot cure is cured with searing iron, and whatever this cannot cure must be considered incurable.
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Knives for Stroke treatment
➢ Decompressive craniotomy (unacceptable complications)
➢ Carotid endarterectomy (limited indications) ➢ EC/IC bypass surgery (it works, but does not
veterbrobasilar arteries
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Pre-procedure Evaluations
➢ Auscultation & Stethoscope ➢ Carotid duplex ultrasonography ➢ Transcranial Doppler ➢ Computed tomographic angiography
Medicine How to up-date
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How to train a Neuro-endቤተ መጻሕፍቲ ባይዱvascular specialists (our experiences at Jinling Hospital) 南京军区总医院神经 内科如何进行神经介入的培训
➢ 2 years of clinical work in stroke management ➢ with experience of diagnostic imaging ➢ 1 years of training on neuro-endovascular
Hippocrates (460-370 BC) 希波
克拉底（约公元前460-370, 称医药 之父）
Medicaments for Stroke
➢Anti-platelet agents (proved by EBM) ➢Thrombolysis (proved by EBM) ➢Anti-coagulation (limited efficacy) ➢Neuroprotection (not proved by EBM) ➢ Herb medicine (not proved by EBM)
The American Heart Association (AHA) How long to do it
The American Academy of Neurology (AAN) How to insure maintenance of skills and
knowledge The American Association of Cycle of Science in