Special Seminar: Endovascular Treatment of Cerebrovascular Diseases: Pushing the Envelope with Transradial Access

The surgical management of cerebrovascular diseases such as intracranial aneurysms, vascular malformations, and large vessel occlusion stroke has increasingly been treated by endovascular intervention. Traditionally, neurointerventions have been performed via transfemoral access (TFA). There is growing robust literature in cardiac endovascular interventions demonstrating the superior safety profile of transradial access (TRA) over TFA, with significant reduction in major bleeding, vascular site complications, and mortality. In addition, patients prefer the TRA approach, with less patient discomfort, early mobility, decreased hospital length of stay, and decreased health-care costs. TRA for neurointerventions was attempted sparingly since early 2000s, but largely abandoned due to limitations of catheter/wire technology at the time to track the tortuous arteries of the head and neck. However, over the last several years, there has been a resurgence of TRA in neuroendovascular procedures including both diagnostic cerebral angiography and interventional procedures. This seminar will be discussing the rationale for TRA access in neurointerventional procedures and the progress made in this area by several institutions including the neuroendovascular program at Buffalo.

Biography:

Michael Tso was born in Calgary, Alberta and grew up in Victoria, British Columbia. After graduating from Queen’s University in 2005 with a BScH degree in Life Sciences, he obtained his MD in 2009 at the University of British Columbia. He then proceeded with residency training in neurosurgery at the University of Calgary, while also completing an in-folded PhD degree in Medical Science at the University of Toronto. He successfully defended his PhD thesis – “Identifying New Therapeutics in Experimental SAH” in 2018, supervised by Dr. Loch Macdonald. After residency completion in 2018, he has been pursuing fellowship training in open cerebrovascular and endovascular neurosurgery at Buffalo, a world leader in advancing neuroendovascular treatment. During his fellowship training, he has embraced a transradial-first approach to neuroendovascular procedures. His research interests lie in understanding cerebrovascular surgical specimens (e.g. thrombectomy clots, etc.) with histological and molecular biology assessments. He also has interests in enrolling patients with large vessel occlusion stroke and subarachnoid hemorrhage into clinical trials and registries.