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Calendar - The 20th Biennial Meeting of the World Society for Stereotactic and Functional Neurosurgery
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class="view-box-header">View</span> <ul> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/session/list"><i class="fa fa-list"></i><span class="hidden-xs"> List</span></a></li> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/session/calendar"><i class="fa fa-calendar"></i><span class="hidden-xs"> Calendar</span></a></li> </ul> </div> </div> <div class="list-view list-view-list"> <div class="card item-container session open st-6-bg" data-id="128" data-streaming="no" > <div class="card-header"> <div class="label-container"><div class="labels"></div> </div> <div class="expand-labels"><i class="fa fa-angle-double-down" aria-hidden="true"></i></div> <div class="actions hidden-xs"> <button type="button" class="btn btn-default pull-left btn-open-new" data-dismiss="modal"><i class="fa fa-expand"></i></button> <button type="button" class="close" data-dismiss="modal" aria-label="Close"><i class="fa fa-times"></i></button> </div> </div> <div class="card-block"> <div class="item-expand"> <h4 class="session-title card-title"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128" class="item-expand-action expand">Flash Presentation Session 05: Radiosurgery & Lesions</a></h4> </div> <div class="details property-auto-width"> <div class="property-container internal_title"> </div> <div class="property-container internal_type"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal_date"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal_time"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal_room"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal_moderators"> <div class="info">Chair(s)</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1709" data-id="1709" class="" >Constantin Tuleasca<small> (Switzerland)</small></a></li> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/66" data-id="66" class="" >Emil D. Isagulyan<small> (Russian Federation)</small></a></li> </ul> </div> </div> <div class="property-container internal_description"> <div class="info">Session Description</div> <div class="property">Each presenter is allocated 7 minutes: 6 min for presentation +1 min for Q&A.</div> </div> <div class="property-container cslide_SESSION_ICON"> </div> </div> <div class="additional-materials"> <ul class="nav nav-pills logged"> </ul> <div class="tab-content"> </div> </div> <div class="item-content"> <div class="card presentation" data-id="157"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">GLOMUS JUGULARE TUMORS TREATMENT BY GAMMA KNIFE RADIOSURGERY: A SINGLE CENTER STUDY</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">04:40 PM - 04:47 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/514" data-id="514" class="" >Aurangzeb Kalhoro<small> (Pakistan)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="157" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-157872016243" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-157872016243" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Glomus jugular tumors are benign vascular tumors and surgical resection is almost impossible. We have treated these tumors with Gamma knife radiosurgery and share our experience.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>This study was conducted at the Neurospinal and Cancer Care Institute, Karachi from January 2010 to May 2020. Thirty-four patients with glomus jugulare tumors treated with gamma knife radiosurgery were included in the study. The comprehensive clinical and demographic characteristics of all patients were collected through a manually designed questionnaire. Computed tomography, digital subtraction angiography, and magnetic resonance imaging were used to make the diagnosis. Data was incorporated and analyzed by SPSS version 26.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>A total of 34 patients were included in the study of which 16(47%) were males and 18(53%) were females with first follow-up after 6 months up to two years of clinical and radiological follow-up. The mean age of the patients was 42.5±13.5 with a minimum age of 20 years and maximum age of 65 years. The KPS scale was 2.09±0.45 and the volume of the tumor was 33.8±22.5 cm3. The improvement was shown in 27 patients of which 14 were males and 13 were females showing insignificance post radiation change. Of all 34 patients, the outcome was recorded as 3(9%) for excellent, 22(64%) for good, 6(17%) for fair and 3(9%) were poor results.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Gamma Knife radiosurgery is a safe and effective primary therapy and salvage therapy for newly diagnosed and recurrent cases of glomus jugulare and tympanicum tumors. It offers a low-risk-benefit treatment option with stable long-term tumor control rates and minimal side effects. Treatment at an early stage before tumors reach large sizes potentially reduces post-treatment complications.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="215"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">FRAMELESS RADIOSURGICAL THALAMOTOMY TO TREAT TREMOR</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">04:47 PM - 04:54 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/694" data-id="694" class="" >Marcello Marchetti<small> (Italy)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="215" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-2151580745535" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-2151580745535" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Considerable positive experience in functional radiosurgery has been reported since Leksell’s first results in 1951, and today, the most recent guidelines define radiosurgery as a viable modality to treat tremor.</p> <p>On the other hand, radiosurgery for functional purposes is usually performed using Gamma Knife, while the frameless procedures are poorly investigated.</p> <p>The aim of the present study is to investigate the role of frameless radiosurgery for tremor.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>Between 2014 and 2023, we treated 11 patients because of an invalidating tremor by using a Cyberknife frameless radiosurgical device according to two prospective, dose escalation protocols. Two patients were excluded from the present analysis, one because of an enrolment error (wrong diagnosis) and one because he/she refused regular follow-up.</p> <p>The radiological (MRI based) appearance of the thalamotomy, as well as the clinical efficacy and the toxicity, were investigated.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>The patients included in this study underwent 75 Gy (two patients), 80 Gy (one patient), 90 Gy (three patients), 100 Gy (two patients) and 110 Gy (one patient) treatments respectively.</p> <p>A circular 5 mm collimator was always used.</p> <p>The treatment targets were always identified as the VIM or the VoA-VoP nuclei.</p> <p>None of the patients who received a dose lower than 90 Gy developed the radiological signs of thalamotomy nor clinical effects. Patients who had a 90 Gy dose or higher, developed the typical cockade like lesion at the planned point.</p> <p>No clinical effects were observed without the radiological appearance of thalamotomy.</p> <p>The latency between the treatment and the effect ranged between 6 and 23 months.</p> <p>One patient developed a clinical relevant radiation necrosis six months post-radiosurgery. No others toxicities were registered.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>The present is an exploratory dose escalation study protocol investigating frameless radiosurgical thalamotomy. Despite the study being limited by the low number of enrolled patients, the results support the frameless thalamotomy as a possible treatment modality to treat the tremor in selected patients. A minimum dose of 90Gy to the 100% isodose line appears to be sufficient to produce a clinical effect but with a long latency. Increasing the dose from 90Gy to 110Gy reduces the latency period without increased toxicity rate.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="463"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">STEREOTACTIC RADIOSURGERY FOR NONCAVERNOUS SINUS DURAL ARTERIOVENOUS FISTULAS: TREATMENT OUTCOMES AND THEIR PREDICTORS</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">04:54 PM - 05:01 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1390" data-id="1390" class="" >Jinu Rim<small> (Korea, Republic of)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="463" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-463489154386" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-463489154386" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Stereotactic radiosurgery (SRS) has emerged as a safe and effective treatment modality for dural arteriovenous fistulas (dAVFs), particularly cavernous sinus (CS) dAVFs. However, the long-term outcomes of non-CS dAVFs are not well known. This study aimed to evaluate the efficacy and safety of SRS for non-CS dAVFs and to investigate the risk factors for incomplete obliteration.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>Between 2007 and 2020, 65 non-CS dAVFs in 63 patients were treated using SRS at a single institution. Demographic characteristics, initial clinical presentations, clinical outcomes, and radiological findings were retrospectively reviewed. The procedure-related complications were assessed. Radiological outcomes were evaluated as complete obliteration, incomplete obliteration, and angiographic worsening, whereas clinical outcomes were evaluated for symptom recovery.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>Complete recovery of symptoms was achieved in 32 patients (32/63, 50.8%) and incomplete recovery was achieved in 10 patients (10/63, 15.9%), while 4 patients showed no change (n = 3) or worsening (n = 1). Complete and incomplete obliterations were achieved in 41 (63.1%) and in 18 (27.7%) lesions. At a median follow-up of 17 months, the overall complete obliteration rate was 63.1%, and the cumulative obliteration rates were 24.6%, 60.0%, 70.0%, and 74.3% at 12, 24, 36, and 48 months, respectively. Six patients underwent retreatment due to angiographic worsening; in 5 of these patients, recruitment of arterial feeders was newly observed in the adjacent sinus, which was not treated in the initial SRS. In the multivariate analysis, high-flow shunt and venous ectasia were associated with incomplete obliteration. No adverse events occurred after SRS.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>The obliteration rates of non-CS dAVFs were variable according to the location. The TS-SS-JB location was associated with complete obliteration. No adverse radiation events were observed. The presence of cortical venous drainage itself was not associated with incomplete obliteration; however, highflow shunts and venous ectasia were predictors of incomplete obliteration. SRS is safe and effective for non-CS dAVFs without high-flow shunts or venous ectasia.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="472"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">HYPOFRACTIONATED GAMMA KNIFE ICON RADIOSURGERY FOR PERIOPTIC MENINGIOMAS: PRELIMINARY EXPERIENCE IN A GROUP OF MORE THAN 100 PATIENTS.</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">05:01 PM - 05:08 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1338" data-id="1338" class="" >Alberto Franzin<small> (Italy)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="472" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-4721767153432" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-4721767153432" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Perioptic meningiomas (cavernous sinus, anterior clinoid and tuberculum sella), defined as those that are less than 3 mm from the optic apparatus, present a treatment challenge when using stereotactic radiosurgery. Achieving tumor control must be carefully weighed against the potential for radiation-induced optic neuropathy (RION), as both tumor advancement and RION carry the risk of causing clinical deterioration. Single-fraction radiosurgery has been considered the gold standard therapy for small brain lesions, but hypofractionation offers an option to treat tumors close to critical structures.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>Between September 2017 and December 2022, 102 patients (81 female and 21 male) with a mean age of 61 years (35-84) underwent hypofractionated Gamma Knife radiosurgery for perioptic skull base meningioma. In 6 patients, we treated multiple meningiomas for a total of 116 tumors. The average tumor volume was 6.55 ml (0.47-20.64), and the median was 5.76 ml.</p> <p>All the patients were treated with the thermoplastic mask and the Cone Beam CT (CBCT) stereotactic system. In most cases, we performed a 5-fraction treatment, with a marginal dose of 25 Gy (5 Gy/fraction); in only 16 patients, we performed a 3-day treatment with a marginal dose of 21 Gy (7 Gy/fraction).</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>We have the radiological follow-up for 85 patients; the clinical follow-up is available in 80. The median radiological follow-up was 35 months, while the median clinical follow-up was 34 months. Tumor control was achieved in 99% of cases (19% reduction, 80% stability of the volume). Most patients had stable clinical symptoms, while we observed an improvement in initial symptoms in 8 patients (10 %). 3 of the symptomatic patients at onset reported a worsening of the symptoms (3.7%). None of the asymptomatic patients became symptomatic.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Our preliminary experience with hypofractionated Gamma Knife Icon proved to be effective and safe in the treatment of patients with perioptic tumors.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="476"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">EFFICACY AND SAFETY OF STEREOTACTIC RADIOSURGERY VERSUS ENDOVASCULAR TREATMENT FOR SYMPTOMATIC CAVERNOUS SINUS DURAL ARTERIOVENOUS FISTULA WITHOUT OPHTHALMOLOGICAL EMERGENCY: A SINGLE-CENTER 10-YEAR EXPERIENCE</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">05:08 PM - 05:15 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1456" data-id="1456" class="" >Jung Woo Yu<small> (Korea, Republic of)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="476" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-476838619142" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-476838619142" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Stereotactic radiosurgery (SRS) is emerging as a treatment option for cavernous sinus dural arteriovenous fistula (CS dAVF). It is less invasive and has a lower complication rate than conventional surgeries. However, little is known regarding the advantages and limitations of SRS compared to those of endovascular treatment (EVT). The aim of this study was to compare the efficacy and safety between EVT and SRS for treatment of CS dAVF.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>Over a 10 years, a total of 86 consecutive patients diagnosed with CS dAVF were treated with EVT or SRS. No neurological deficit due to ICH or seizure was noted in any of the patients. Ultimately, 70 patients (EVT 33, SRS 37) were included in this study. Demographic characteristics, initial clinical presentations, clinical outcomes, and radiological findings were retrospectively reviewed and compared. Procedure-related complications were assessed after the treatments.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>The patients’ baseline characteristics and angiographic features of CS dAVF were not significantly different between the EVT and SRS groups. Conjunctival symptoms were more frequently noted in the EVT than in the SRS group (69.7% vs 40.5%, p = 0.015). After EVT, initial complete obliteration was achieved in 20 cases (60.6%). Complete obliteration was achieved at 6 months in 86.4% of cases with EVT and in 77.8% of those treated with SRS, and at 12 months in 86.4% cases with EVT and in 94.4% of those treated with SRS. Worsening of symptoms developed at 1 month in 24.2% of cases with EVT and in 5.4% of those treated with SRS (p = 0.038); at 6 months in 22.6% of cases with EVT and in 10.8% of those treated with SRS; and at 12 months in 30.0% of cases with EVT and in 13.5% of those treated with SRS (p = 0.099). Procedure-related morbidity and mortality occurred more frequently in the EVT than in the SRS group (27.3% vs 8.1%, p = 0.034).</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Both EVT and SRS were effective for the treatment of CS dAVF without ophthalmological emergency. However, procedure-related morbidity and mortality was less frequent in SRS than in EVT, and consequently SRS may be more advantageous in terms of safety.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="133"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">RADIOFREQUENCY ABLATION OF THE CENTROMEDIAN NUCLEUS IN THE TREATMENT OF REFRACTORY STATUS EPILEPTICUS</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">05:15 PM - 05:22 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/435" data-id="435" class="" >Gustavo Aguado Carrillo<small> (Mexico)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="133" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-1331816299600" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-1331816299600" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>In a pilot study conducted previously in six patients with generalized and multifocal epilepsy secondarily refractory to drugs, in whom radiofrequency ablation (RFA) of both centromedian nuclei was performed, a significant decrease in seizure rate was observed. On this basis, we decided to apply this novel procedure in patients with refractory status epilepticus (RSE).</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>Here, we describe two cases of RSE in which bilateral radiofrequency ablation of the CMN was performed due to the lack of response to conventional pharmacological treatment in intensive care.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>Immediately after the procedure, we observed total remission of status epilepticus in both cases, allowing the removal of mechanical ventilatory support and discharge from the intensive care unit. No sequelae were observed in the neurological status of both patients. At 3 and 5 months of follow-up, patients report an overall decrease in the rate of generalized seizures compared to previous status epilepticus.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Radiofrequency ablation of the centromedian thalamic nucleus is a safe and effective method of treating RSE. In both cases reported here, an immediate clinical response was observed with remission of status epilepticus without relapses at 3 and 5 months of follow-up.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="304"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">IMMUNOTHERAPY IMPROVES LOCAL CONTROL FOR LARGE (>4CC IN VOLUME) LUNG CANCER BRAIN METASTASES COMPARED TO RADIOSURGERY ALONE</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">05:22 PM - 05:29 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1136" data-id="1136" class="" >Michael Schulder<small> (United States of America)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="304" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-304551382660" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-304551382660" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>Stereotactic radiosurgery (SRS) is a key pillar of treatment for patients with brain metastases (BM). However, rates of local control are worse for patients with large BMs despite advances in SRS. To this end, immune checkpoint inhibitors (ICIs) may provide synergistic effects when implemented alongside SRS, which may improve tumor local control. However, this paradigm has not been investigated for large BMs. We demonstrate our single-center, retrospective experience with SRS with and without ICI for the treatment of patients having lung and breast cancer BM greater than 4cc in volume.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>Patients who received SRS therapy for the treatment of lung cancer BMs greater than 4cc in volume at Northwell Health between January 2017 and June 2023 were retrospectively identified. Local failure events (LF) and utilization of immunotherapy agents were identified and collected. Rate of local control was compared between the subgroup receiving SRS+ICI compared to SRS alone.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>A total of 155 large lung BMs (in 120 patients) greater than 4cc were identified. Of these, 17 patients (22 BMs) received SRS+ICI. There was no significant difference in the median BM volume (10.8cc for SRS only, 10.9cc for SRS+ICI; p=0.225) between subgroups. There was a significant difference in local control rate between SRS only and SRS+ICI (HR for SRS+ICI: 0.178; p=0.032). Six- and 12-month for LF rates were 6.1% and 8.7% for SRS only, and there were no LF events for patients receiving SRS+ICI.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>We present one of the few studies demonstrating clinical outcomes for SRS+ICI for patients with large lung BMs. ICI provided alongside SRS yields improved rates of local control compared to SRS only. Further investigation will identify optimal timing of ICI therapy relative to SRS and elucidate the molecular mechanisms underlying this synergy.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> <div class="card presentation" data-id="442"> <div class="card-header"> <div class="actions hidden-xs"> </div> </div> <div class="card-block"> <h4 class="card-title">ARE WE BARKING THE WRONG TREE: A NOVEL WAY OF PROGRAMMING THE DBS IMPLANTABLE PULSE GENERATOR</h4> <div class="details property-auto-width"> <div class="property-container internal s"> <div class="info">Session Name</div> <div class="property"><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/confcal/show/session/128">0680 - Flash Presentation Session 05: Radiosurgery & Lesions <small>(ID 128)</small></a></div> </div> <div class="property-container internal s"> <div class="info">Session Type</div> <div class="property">Flash Presentations</div> </div> <div class="property-container internal s"> <div class="info">Date</div> <div class="property">09/05/2024</div> </div> <div class="property-container internal s"> <div class="info">Session Time</div> <div class="property">04:40 PM - 05:40 PM</div> </div> <div class="property-container internal s"> <div class="info">Room</div> <div class="property">St. Gallen 1+2</div> </div> <div class="property-container internal p"> <div class="info">Lecture Time</div> <div class="property">05:29 PM - 05:36 PM</div> </div> <div class="property-container internal p"> <div class="info">Presenter</div> <div class="property"><ul class="persons"> <li><a href="https://cslide.ctimeetingtech.com/wssfn24/attendee/person/1325" data-id="1325" class="" >Raj V. Agarbattiwala<small> (India)</small></a></li> </ul> </div> </div> </div> <div class="item-content"><div class="additional-materials"> <ul class="nav nav-pills logged" data-module='confcal' data-log_entity_id="442" data-log_entity_type_id="25"> <li><a data-toggle="pill" href="#presentation-abstract-442788249263" data-log="ATTENDEE_CONFCAL_PRESENTATION_EXPAND_ABSTRACT">Abstract</a></li> </ul> <div class="tab-content"> <div id="presentation-abstract-442788249263" class="tab-pane"> <h4 class="pane-header">Abstract</h4> <div class="abstract"><div class='abstract-section' section-id='0b79795d3efc95b9976c7c5b933afce2'><h4 class='section-title'>Introduction</h4><p>The evolution of Deep Brain Stimulation (DBS) technology, featuring multi-parametric adjustments and directional leads, has significantly enhanced therapeutic outcomes while also increasing the complexity of programming. This study compares conventional Standard of Care (SOC) programming, which relies on clinical assessment and image-guided programming, with a novel Stimulation-Induced Side-Effect (SISE)-guided programming, which leverages the occurrence of side effects to refine the determination of the stimulation contact point.</p></div><div class='abstract-section' section-id='20c51b5f4e9aeb5334c90ff072e6f928'><h4 class='section-title'>Methods</h4><p>SOC programming is used for all the patients at our center. SISE-guided programming was offered to the patients who failed or had suboptimal responses. SISE-guided programming determines the threshold current that elicits side effects to estimate the DBS lead's anatomical positioning for precise current steering. We present three cases of Parkinson’s disease patients who benefitted from the SISE-guided programming. All patients had undergone DBS using directional lead and Boston Scientific (USA) implantable pulse generator.</p></div><div class='abstract-section' section-id='fd69c5cf902969e6fb71d043085ddee6'><h4 class='section-title'>Results</h4><p>The stimulation level with SISE-guided programming was maintained the same for three leads, moved ventrally by 0.5 contact points for two leads and dorsally by 0.6 contact points for one lead relative to SOC programming. SISE-guided adjustments resulted in an average increase in current amplitude of 1.7 mA (range: 0.5 mA - 2.1 mA). Furthermore, the current direction was altered from posterior to medial for two leads and from posterior to lateral for one lead, with adjustments not exceeding 90 degrees. Notably, in two additional instances, the current direction was changed from a circumferential spread to a more focused posteromedial and posterolateral distribution. This precision programming enhanced symptom control in two patients with tremors and one with bradykinesia and freezing gait.</p></div><div class='abstract-section' section-id='b651e8a99c4375feb982b7c2cad376e9'><h4 class='section-title'>Conclusions</h4><p>Selecting optimal contact points, current direction, and amplitude is challenging when using SOC programming, especially considering the STN's small size and the VTA's spherical shape. SISE offered a larger margin of safety, which otherwise would not have been realized in SOC-based programming. This provided enhanced clinical benefits without any undue side effects. SISE-guided programming emerges as an alternative approach.</p></div></div> <a class="nav-pills-collapse" href="#">Hide</a> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div></div> </div> </div> </div> <div id="footer"> <div class="footer text-center"> <div class="footer_wrapper"> <i class="fa fa-chevron-up" aria-hidden="true" style="display: none;"></i> <p>Programme and Faculty are preliminary and subject to change.<br /> <b><a href="http://www.surveymonkey.com/r/MSHLPYT?c=7647_The 20th Biennial Meeting of the World Society for Stereotactic and Functional Neurosurgery_2024" target="_blank"><span>Give Feedback</span></a></b><br /> <span>© 2024 cSLIDE </span><a href="http://www.ctimeetingtech.com" target="_blank"><span>CTI MEETING TECHNOLOGY</span></a><span>. 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