Introduction and Goals
Advancements in neuroendovascular technologies are rapidly changing the therapeutic landscape in vascular neurology and neurosurgery. The contemporary neurologist must be familiar with this therapeutic area in order to offer the most appropriate care to his or her patients.
The goal of this senior-level elective rotation is to allow the resident neurologist to become familiar with neuroendovascular technology and its appropriate application to patients with ischemic and hemorrhagic stroke, vascular malformations, and brain tumors.
Objectives and Evaluation Matrix
As with all of the neurology rotations, the specific objectives are reflected in the entrustable professional activities and individual milestones listed below. These form the basis for the end-of-rotation evaluation. (Please see the section End-of-Rotation Evaluations above for the list of milestone abbreviations).
| Rotation Objectives | ||
| Upon completion of the curriculum, residents will . . . | ||
| # | Description | Milestones |
| 1 | Demonstrate a basic understanding of radiation safety, fluoroscopy, and the use of contrast agents | MK2 |
| 2 | Understand the angiographic anatomy of the brain, spine, and head and neck | MK1, MK2 |
| 3 | Describe basic treatment principles for common neurovascular pathologies such as atherosclerosis, dissection, acute thrombotic occlusion, aneurysm, and arteriovenous malformation | PC5, PC6, MK2 |
| 4 | Understand principles of peri-procedural antithrombotic and blood pressure management | PC5, PC6 |
| 5 | Understand the basic principles of anesthesia selection and monitoring of recovery | PC5, PC6 |
| 6 | Demonstrate basic knowledge of the catheter and delivery systems used in neuroendovascular surgery | PC5, PC6 |
| 7 | Understand key elements of pre-procedural data acquisition, obtaining informed consent, and risk-benefit assessment | SP3, SP4, PL1, PR1, IC1, IC3, IC4 |
| 8 | Communicate effectively with requesting clinical services, nurses, and other members of the patient’s team | SP3, SP4, PR1, IC3, IC4 |
| Milestones | ||
| Please grade the resident on any of the following milestones you were able to evaluate during this rotation: | ||
| PL2, PR2 | ||
Schedule
Every day except Wednesdays, the cases in the neuroangiography suite begin at 07:30 am. Residents and fellows are expected to be present by 7am. For elective cases, the residents and fellows should be familiar with the patient’s history, imaging studies and basic treatment plan. Cases are often re-discussed with the neuroendovascular fellow and neurosurgery residents before the case, and this is an ideal time for the neurology resident to learn about the procedures.
Residents will attend the neurovascular conference on the second Monday of the month. This takes place in the Puletti Conference Room (D4/473) at 4pm. Residents should also attend the Neurosurgery Morbidity and Mortality conference held almost every Wednesday morning at 7:00 am in G5/152. They may wish to stay for the Neurosurgery Grand Rounds that follows.
Work Hours
The estimated average number of work hours per week is 50-60. There are no call responsibilities required during this rotation.
It is the responsibility of each resident to be in communication with the supervisory attending regarding work hours. In the event that any of the ACGME work hours regulations are in jeopardy of being violated, the supervisory neurology attending physician must be notified immediately. It will be that attending’s responsibility to rectify the situation immediately by appropriate means.
Suggested References
Grossman, R. I., & Yousem, D. M. (2010). Neuroradiology. Philadelphia, Pa.: Mosby Elsevier.
Latchaw, R. E., Kucharczyk, J., & Moseley, M. E. (2005). Imaging of the nervous system : diagnostic and therapeutic applications. Philadelphia, Pa.: Mosby.
Morris, P. (2013). Practical neuroangiography. Philadelphia [etc.]: Wolters Kluwer / Lippincott Wiiliams & Wilkins.
Latest revision: 05-14-2021
