Trends in the Treatment of Cerebrovascular Diseases

PD Dr. med. Giuseppe Esposito, PhD is a Leading Senior Neurosurgeon at the University Hospital Zurich (USZ), specializing in cerebrovascular and skull base surgery, with a particular focus on microsurgical cerebral revascularization (bypass and carotid endarterectomy). His research centers on microsurgical training and the analysis of brain hemodynamics using non-invasive MR techniques. He directs the Zurich Microsurgery Lab, a simulation and research center in microsurgery and neurosurgery. Giuseppe Esposito has authored over 120 scientific publications, organized numerous international congresses, and received several awards, including the UZH 3R Award and the Johns Hopkins CAAT Grant. He is also a panel member of the EANS Vascular Neurosurgery Section. Prof. Yasuhiko Kaku studied medicine at Gifu University, Japan. He trained under Prof. Yonekawa at the National Cardiovascular Center, Japan and obtained board certification in neurosurgery. At the Zürich University Hospital, Switzerland, he engaged in the microsurgical treatment of complex intracranial lesions with Prof. Yonekawa. Prof. Kaku has developed the novel treatment of cerebral vasospasm using intra-arterial Papaverine, the surgical approach to the intrinsic midbrain lesions and STA-MCA bypass under local anesthesia. He was awarded the Watanabe Prize of the Japanese Neurosurgical society in 1992. He is known as a pioneer hybrid neurosurgeon who performs both open surgery as well as endovascular procedures for the treatment of intracranial vascular lesions. Dr. Martina Sebök, PhD, studied medicine at the University of Ljubljana, Slovenia. She trained under Prof. Luca Regli at the Department of Neurosurgery, University Hospital Zurich, and obtained board certification in neurosurgery in 2022. In the same year, she earned a PhD in Clinical Science from the University of Zurich. In 2024, she completed a fellowship in open cerebrovascular neurosurgery at Toronto Western Hospital, Canada, under the supervision of Prof. Ivan Radovanovic. Dr. Sebök is currently a staff neurosurgeon specializing in cerebrovascular neurosurgery at University Hospital Zurich. As a clinical neuroscientist, she advances cerebrovascular research through innovative applications of advanced quantitative blood oxygenation level-dependent (BOLD) MRI with hypercapnic challenge, enabling precise assessment of cerebrovascular reactivity (CVR) across a wide range of cerebrovascular diseases, brain tumors, and migraine. Notably, BOLD-CVR plays a crucial role in guiding decision-making for cerebral revascularization via EC-IC bypass in patients with Moyamoya vasculopathy and large-vessel atherosclerotic disease. Luca Regli Prof. Tetsuya Tsukahara studied medicine at Kyoto University, Japan. He trained under Prof. Handa at the department of neurosurgery, Kyoto University and earned a PhD in the research of pathophysiology of the cerebral artery and cerebral stroke. At the University of Virginia USA, he engaged in the clinical research of neurosurgery with Prof. Kassel. After coming back to Japan, he obtained board certification in neurosurgery and worked under Prof.Yonekawa at the department of cerebrovascular surgery, the National Cardiovascular Center, Japan. In 1997 he became a chair of the department of neurosurgery of the Kyoto Medical Center and in 2014 Clinical professor of the department of Kyoto University. He organized international clinical research on unruptured cerebral aneurysm between Europe and Japan, with Prof. Yonekawa, Zurich and Prof. Sakurai, Sendai, Japan and opened a research meeting of  Swiss-Japanese joint conference on cerebral aneurysm in 2001. This meeting has been developed now as The European-Japanese Cerebrovascular Congress (EJCVC). 10th EJCVC in Kyoto Japan was held on 13 -16 November 2022 with chair of Prof. Tsukahara and co-chairs, Prof. Kaku, Prof. Regli, and Dr. Esposito.

• Aneurysms and SAH.- 1. Clinical evidence for intravenous milrinone to treat secondary cerebral ischemia after aneurysmal subarachnoid hemorrhage - A narrative review.- 2. Tenascin-C as a target for intervention in delayed cerebral ischemia after subarachnoid hemorrhage.- 3. Introducing Bayesian Analysis for Clinicians: Sex-Associated Risk Assessment of Intracranial Aneurysms.- 4. Challenges of the Endovascular Approach for Difficult Cerebral Aneurysms.- AVM and dAVF.- 5. Evaluation of motor function in surgery for cerebral arteriovenous malformations by 3-tesla magnetic resonance tractography.- 6.    The forefront of gamma knife radiosurgery for brain arteriovenous malformations: our history of treatment optimization over 30 years and the modern outcomes.- 7. Role and efficacy of direct surgery in the management of intracranial dural arteriovenous fistulas.- 8. Paraspinal Arteriovenous Shunt Associated with PTEN Hamartoma Tumor Syndrome: A Case Report and Literature Review.- 9. Efficacy of high-resolution cone beam CT for the endovascular treatment of dural arteriovenous fistulas.- Bypass and Moyamoya.- 10. Cerebral ischemic complications of surgical treatment in patients with Moya Moya Disease. 11. Long-term outcome of MoyaMoya disease.- 12. Efficacy and safety of combined revascularization surgery for Moyamoya disease: Standard procedure and peri-operative management.- 13. Comparison of Exoscopic and Microscopic Superficial Temporal Artery to Middle Cerebral Artery Bypass Neuroimaging.- 14. New classification of the degree of cerebrovascular insufficiency in patients with Moya-Moya disease measured by ASL MRI Perfusion.- 15. ADC Threshold Indicating the Ischemic Region for Predicting Efficacy in Thrombectomy.- 16. Novel hemodynamic parameters for cerebral ischemia in patients with occlusive cerebrovascular disease using dual ASL perfusion imaging.- Cavernoma & others.- 17. Epidemiology and aetiology of cerebral cavernous malformations.- Innovations.- 18. Experiences and practical implications using a hybrid operating room.-19. Artificial Intelligence and Augmented Reality in Vascular Neurosurgery.- 20. Educational impact of an annotation system integrated with an exoscope for cerebral aneurysm surgery: case description.- Editorials.- 21. Microneurosurgical training n simulators: the Zurich microsurgery lab experience.