NeuroEndovascular Surgery Fellowship

Program Curriculum

The Neuroendovascular Surgery Fellowship training program at the Medical University of South Carolina is a two-year fellowship training program that provides a well-balanced clinical, research and teaching curriculum emphasizing the management and treatment of cerebrovascular diseases.

The NES fellowship provides strong clinical training in the performance and interpretation of all aspects of neuroendovascular surgery including diagnostic angiography, embolization of intracranial aneurysms, AVMs, dAVFs, sdAVFs, acute ischemic stroke, intra- and extra-cranial atherosclerotic disease, tumor embolization, sclerotherapy for congenital vascular anomalies and spine augmentation (kyphoplasty).

MUSC is a high-volume, tertiary center that offers extensive exposure to cerebrovascular pathology with an integrated collaboration between neurosurgery, neurology, ENT and the ED. Last year over 1600 procedures were performed: over 250 aneurysm coilings, 150 acute ischemic strokes, 50 AVMs and dAVFs, 50 tumor embolizations and 40 kyphoplasties.

First year fellows spend dedicated time in the NSICU as well as time establishing strong fundamentals in diagnostic angiography and neurovascular anatomy. First year fellows are expected to participate in all aspects of patient care from the initial presentation to discharge. Fellows assist in the performance of all neuroendovascular procedures and are involved actively in daily work and teaching rounds on the clinical service.

Second year fellows are given graduated responsibility in the performance of diagnostic and interventional procedures based on their ability. We are a hands-on fellowship program with an emphasis in advanced techniques. Fellows will learn the essentials of aneurysm embolization from stent coiling, balloon remodeling and flow diversion as well as advanced techniques in acute stroke and tumor embolization. During this year, fellows are also given increasing clinical responsibility in the management of neurovascular patients in the inpatient and outpatient setting.

At the completion of the two-year fellowship training program fellows are expected to exceed the SNIS membership criteria of interventional cases and be ready for clinical practice.

Research

There is an extremely active clinical and laboratory research program which provides the fellows ample opportunities to participate in research. We participate in most major aneurysm and stroke trials. Fellows are expected to participate in all aspects of clinical and basic research as well publish at least one major manuscript per year.

Projects are ongoing within the division to study the pathophysiology and three-dimensional angioarchitecture of cerebral AVM's using selective micro-angiography to guide endovascular and gamma knife therapy. Animal models are being developed to emulate side wall and bifurcation type aneurysms within the cerebral circulation. The division has been worldwide leader in the development of novel endovascular treatments of cerebral aneurysms in the past decade.

STAR (Stroke Thrombectomy & Aneurysm Registry)

The STAR registry is hosted by the Department of Neurosurgery at the Medical University of South Carolina, and collaborators across the country have access to the data by request analyses for pertinent questions. The STAR registry serves as a multicenter initiative to track patient outcomes after stroke thrombectomy or endovascular aneurysm treatment using data from the real-world practice. The ultimate purpose is to optimize patient outcomes using large patient cohorts and compile knowledge and expertise in endovascular management of cerebrovascular diseases across the globe. The registry includes centers from the U.S. and globally to provide a data source for answering questions relevant to patient selection, effects of new interventions and techniques, and predictors of technical and clinical outcomes.

Conferences

There are regular conferences which are attended by all NES staff and fellows.

• Weekly Neurosurgery conference
• Bi-weekly cerebrovascular conference
• Departmental grand rounds lectures, monthly
• Weekly clinical neuroscience conference: jointly with departments of neurosurgery, neuroradiology, pathology, neuro-otology.
• Monthly M&M conference.
• Monthly journal club.
• Various optional conferences in affiliated departments.