Endovascular Surgical Neuroradiology Fellowship

The Endovascular Neurosurgery fellowship is designed to provide an organized, supervised, full-time educational experience in this subspeciality area, focusing on the management of patients with neurological disease, the performance of endovascular surgical neuroradiology procedures and the integration of endovascular surgical neuroradiology therapies into the clinical management of patients. Develop endovascular skills so the graduate can operate as an effective independent academic practitioner. Development and consolidation of diagnostic skills and technical knowledge involving the full range of diagnostic modalities including state of the art imaging techniques employed in the assessment of ESN patients. During the advanced year of training the fellow should demonstrate mastery of all NES milestones as described by SNS/CAST through Level 5 for cerebrovascular diseases: arterial and venous angiographic anatomy of the brain, spinal cord, head, neck and spine including collateral anastomoses, anatomic variants and modifications induced by disease processes, bony and soft tissue anatomy and physiology of brain, head and neck and spine, cerebral blood flow and its physiology and pharmacology, the technical aspects of endovascular neurosurgery including: arterial and venous access techniques, catheter systems, nomenclature, and selection, the spectrum of embolic and sclerosing agents, the spectrum of stents, balloons, and other endovascular devices, aneurysm treatment, arteriovenous malformation embolization, complications of endovascular procedures and their management, treatment of dural arteriovenous fistulae, treatment of acute cerebral ischemia, treatment of cerebral vasopasm, provocative testing, electrophysiologic monitoring, extracranial occlusive disease including atherosclerotic disease and dissection, intracranial occlusive disease including atherosclerotic disease and dissection, traumatic vascular lesions of the CNS, head and neck and spine, balloon test occlusions, tumor or vascular lesion embolization, intracranial and head and neck, embolization for epistaxis, spinal embolization, pharmacologic agents, contrast materials, sedatives and anesthetics, analgesics, thrombolytics, antiplatelet agents, antithrombotics, vasoactive agents including vasopressors and vasodilators, periprocedural follow-up, patient evaluation and decision making, neurointensive care and long-term follow-up. The continuity of care must be of sufficient duration so that the trainee is familiar with the outcome of these procedures. A minimum of 250 ‘interventional’ procedures as primary operator are required to ensure that the trainee receives the needed exposure to the diversity of cerebrovascular diseases and the endovascular procedures brought to bear in their treatment. This number should include: 40 aneurysm treatments including 10 ruptured aneurysms, 20 intracranial embolizations (AVM, AVF, Tumor), 25 intracranial or extracranial stent placements (at least 5 in each category, and may include stents or flow divertors for aneurysms), 30 acute ischemic stroke treatments ,10 intracranial infusions (e.g. vasospasm, chemotherapy, stroke), 5 extracranial embolizations, 5 spinal angiograms and/or embolizations A candidate unable to complete the required interventions during the 12 months must extend their training and/or seek training at other institutions to accomplish this requirement. The program must perform at least 250 therapeutic NES procedures per year. The fellow should undertake investigations into the various areas of NES, su