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Houston Methodist hosts first World Conference on Cerebral Flow Diversion

Houston Methodist hosts first World Conference on Cerebral Flow Diversion

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The Houston Methodist Institute for Academic Medicine held last week the first-ever World Conference on Cerebral Flow Diversion.

Approximately 40 physicians, residents, fellows and health care professionals from across the Texas Medical Center attended the inaugural two-day educational program to hear from world leaders and experts in flow diversion, a new endovascular technique that offers an alternative method to treating unruptured aneurysms that also mitigates the risk of rupturing.

Traditionally, doctors would insert a coil attached to a microcatheter in the aneurysm sac to block blood flow into an aneurysm, preventing the aneurysm from rupturing and releasing blood into the surrounding brain area if performed successfully. Because the procedure requires doctors to enter through the aneurysm, this increases the risk of rupturing the sac during surgery. A ruptured aneurysm, called a subarachnoid hemorrhage, has a mortality rate of 46 percent and, if left untreated and unrepaired, that death rate for a second hemorrhage raises to 80 percent.

“We put a very dense stent that [is made of] a lot of metal and prevents flow going to the aneurysm but still allows flow into the parent vessel,” said Gavin Britz, M.D., co-director of the Houston Methodist Neurological Institute and course director of the World Conference on Cerebral Flow Diversion. “This is has really changed the way we treat brain aneurysms in certain ways.”

Unlike any program of its kind, the event was designed to give attendees the opportunity to explore and learn more about clinical management of intracranial aneurysms with flow diversion, but it also allowed them to view a live surgery using the technique and featured a veritable array of neurosurgery experts from all across the globe discussing a range of topics, including the long-term efficacy of coiling, the management of persistent aneurysm after flow diversion and challenges.

Pedro Lylyk, M.D., director and chief executive officer of Endovascular Neurosurgery and Interventional Radiology in Buenos Aires, Argentina, presented a historical perspective on how flow diversion functioned over the past decade. Due to the fact that regulatory systems in Argentina are not as complex as those here in the U.S., Lylyk’s access to the new products have allowed him test the technology ahead of other countries and provided a unique insight for him to share with the rest of the medical community.

“If you just practice medicine in isolation, you don’t really get the opportunity to improve nearly as much as if you are able to see what other people are doing, as well,” said fellow speaker Henry Woo, M.D., professor of neurological study and co-director of the Cerebrovascular Center at Stony Brook University Hospital. “It’s that communication and sharing of knowledge and experience was really the major benefit of the conference.”

Because flow diversion is a relatively new technique that emerged over the past 10 years, Britz and his team plan to hold the conference every two years and dedicate time and research efforts to allow the field to mature, validate their findings and gain a better understanding of the risks associated with it.

“Obviously, now we’re still learning the device in some clinical cases, but we need to get more involved in research long term regarding the basic science of how flow diversion works, how we can prevent complications and make complications better,” Britz said.

Although future attendees will have to wait until 2018 for the second World Conference on Cerebral Flow Diversion, Britz echoed the TMC’s model of collaboration, acknowledging the importance of continuing cross-institutional and multi-disciplinary efforts to expand their understanding of the technique.

“People can see that, when we get a group of people, we can cross-fertilize,” Britz said. “It’s an ongoing thing that’s going to allow for more relationships to develop, as well, on a research side and a clinical side. That’s important.”

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