Cerebral ECIC Bypass Fellowship

Cerebral ECIC Bypass Fellowship

2 months, Czech Republic, České Budějovice & Ústí nad Labem

Fellowship Guarantors:

Jiri Fiedler, MD, PhD, Director of the Vascular Program
Department of Neurosurgery and Comprehensive Neurovascular Center
České Budějovice, Czech Republic
email: fiedler@nemcb.cz

Martin Sames, MD, PhD, Professor and Chairman
Department of Neurosurgery, Masaryk Hospital
Ústí nad Labem, Czech Republic
email: martin.sames@kzcr.eu

The two-month fellowship will be divided to clinical and laboratory parts:
In the clinical part, physicians will gain the ability to indicate and to perform open microsurgical procedures preventing or treating brain ischemia. This includes carotid endarterectomy in symptomatic and asymptomatic patients, cerebral ECIC bypass in moyamoya disease and haemodynamic ischaemia including urgent stages.
In the laboratory part, fellows will train microsurgical bypass at high frequency in laboratory conditions on silastic vessels and in the second phase on experimental animals.
After certification, the graduate will be able to responsibly assess the clinical indication, selection of CVRC examination and will be equipped to perform ECIC bypass in clinical conditions.

1. Indication - diagnostic algorithm for ECIC bypass in hemodynamic ischemia
   TCD evaluation of cerebrovascular reactivity (CVRC) of patients with ICA occlusion, perfusion CT evaluation, SPECT evaluation, QMRA (NOVA) for supratentorial and infratentorial ischemia (Veritas Study).
2. Lab training for bypass
   Daily training for ECIC bypass (end to end, side to side, side to side) - within the first phase on the silastic tubes (Ústí nad Labem) and during the second phase on experimental animal model (České Budějovice).
3. Clinical training
   Daily clinical practice in CVRC examination in patients, assistance in vascular operations (carotid endarterectomy, bypass), after improving laboratory skills also perform these operations under the supervision of a mentor, control and examination of patients after bypass and CEA operations.
4. Certification and fellowship evaluation
   Oral examination and discussion the real clinical cases, ECIC bypass test (time of the suture, quality of the anastomosis), evaluation of the fellowship.

Tentative week program (week 1^st - 4^th, Ústí nad Labem):

During this fellowship the physician will observe in the outpatient clinic, hospital setting, ICU, operating rooms (ORs), anatomical laboratory, and attend all educational conferences.

During your fellowship, your tentative schedule will be as follows:
Monday – OR vascular cases, Lab training (ECIC bypass training)
Tuesday – conference, OR, Lab training
Wednesday – conference, OR vascular cases
Thursday – anatomical laboratory, vascular lab, skull base lab, research, occasionally dinner and discussion
Friday – neurosurgical conference, journal club, morbidity mortality conference, TCD evaluation of cerebrovascular reactivity (CVRC) of patients with ICA occlusion (diagnostic algorithm for ECIC bypass), QMRA (NOVA) for supratentorial and infratentorial ischemia (Veritas Study), outpatient clinic, neuroradiology conference

Tentative week program (week 5^th - 8^th, České Budějovice):

During this fellowship physician will observe workflow in the Comprehensive Stroke Center. In neurosurgery - the outpatient clinic, hospital setting, ICU, operating rooms (ORs), animal laboratory, and attend all educational conferences.

During your fellowship, your tentative schedule will be as follows:
Monday – OR vascular cases, Lab training (rat inguinal and carotid models, vessel preparation and sutures)
Tuesday – briefing, OR vascular cases
Wednesday – briefing, OR vascular cases
Thursday – animal laboratory, occasionally dinner and discussion
Friday – briefing, OR vascular cases QMRA (NOVA) for supratentorial and infratentorial ischemia (Veritas Study), outpatient clinic, neuroradiology conference, comprehensive stroke center workflow

Application details:
1. Send the application to the email of the fellowship guarantors: martin.sames@kzcr.eu fiedler@nemcb.cz
2. Attach your CV
3. Fellowship is free of charge: participants pay only for food and accommodation (we will help organize it according to the participant's requirements)

Jiri Fiedler
Martin Sames
Cerebrovascular Diseases and Therapy Committee WFNS

Luis A B Borba, MD PhD, IFAANS
Chairman Education & Training Committee WFNS

March 21, 2022