On March 12, 2025, the Essen Advanced Interventional Surgery Live Course (ALICE 2025), which has attracted much attention in the field of neurointervention worldwide, opened grandly in Essen, Germany. The conference was led by Professor René Chapot, a world-renowned neurointervention expert and director of the Department of Neurointervention at Alfred Krupp Hospital in Essen, Germany, and brought together top neurointervention experts from around the world to discuss and showcase the latest progress and technological innovations in the field of neurointervention.
During the three-day conference, the expert teams from the three centers in Essen, Santander and Bordeaux will demonstrate 15 neurointerventional surgeries. In addition, the conference also has multiple discussion and speech sessions, covering aneurysms, arteriovenous malformations, dural arteriovenous fistulas, chronic subdural hematomas, cerebral vascular stenosis and other diseases, and is committed to providing a high-level academic exchange platform for participants.
Professor Gu Yuxiang's team from Huashan Hospital Affiliated to Fudan University presented a keynote speech entitled "Treatment of Chronic Subdural Hematoma: Future Perspectives". CSDH is characterized by high morbidity, high recurrence rate and high disability rate. Drug treatments such as atorvastatin and tranexamic acid are making continuous progress; middle meningeal artery embolization (MMAE) has great potential, and the China MAGIC-MT trial, as the largest clinical validation to date, has provided supportive evidence. Future directions may focus on the therapeutic potential of bevacizumab and endoscopic membrane resection, as well as the development of AI recurrence prediction models and new embolic materials.
Professor Walter Wohlegemuth from Martin Luther University Halle-Wittenberg in Germany gave a keynote speech on "Electroembolization of AVMs", which discussed in detail the potential effectiveness of bleomycin electroembolization therapy (BEET) for AVMs. Bleomycin enhances the efficacy through reversible electroporation and increases the drug concentration in the lesion through continuous intra-arterial perfusion, which seems to be effective in the treatment of AVMs. Clinical cases have shown that BEET can significantly reduce recurrence and bleeding in AVMs in complex areas such as the maxillofacial region and the ear. The technical optimization directions include electrode layout, standardization of infusion parameters, and multimodal combined treatment.
Professor Fabian Arnberg from Karolinska Institute in Sweden gave a keynote speech on "FD Treatment of Ruptured Aneurysms". FD is suitable for the first-line treatment of wide-necked, ruptured dissecting aneurysms, but it increases the risk of bleeding and thrombosis. In neurointensive care, antiplatelet management requires caution, involving aspects such as drug selection, dose adjustment, and laboratory testing. Imaging evaluation is of great significance for screening vascular wall damage, hematoma distribution, and postoperative follow-up. Complex cases often require combined coil or double FD implantation, and early postoperative imaging monitoring is very important. The conflict between the timing of EVD implantation and antiplatelet management requires the formulation of an individualized strategy, and multidisciplinary collaboration is recommended to formulate a NICU management protocol. In short, FD treatment of ruptured aneurysms requires precise anatomical reconstruction, dynamic dose adjustment, and full radiological monitoring to improve efficacy and reduce the risk of complications.
Professor Tufail Patankar from the University of Leeds, UK, delivered a keynote speech entitled "FD Treatment of Giant Aneurysms". Untreated giant aneurysms have a high risk of rupture and death. Treatment options need to take into account the patient's age, rupture status, aneurysm morphology, and the experience of the medical team.Although FD treatment is reasonable, it also presents significant technical challenges, including difficulty in stent deployment and the risk of delayed rupture. Key clinical practices have shown that combined coil embolization can increase the occlusion rate, but the risks of antiplatelet therapy need to be balanced. Multicenter studies have emphasized that the risk of neurological morbidity and mortality after FD treatment for posterior circulation aneurysms is higher than that for anterior circulation aneurysms.