IDEAS 2023

October 25, 2023

IDEAS, the Interdisciplinary Endovascular Aortic Symposium, takes place every year during CIRSE. A veritable congress-within-a-congress, IDEAS promotes multidisciplinary collaboration in aortic treatment and features experts from both interventional radiology and endovascular surgery. This year’s IDEAS Scientific Programme Committee, under the direction of Chairperson Prof. Eric Verhoeven and Deputy Chairperson Prof. Hicham Kobeiter, compiled an exciting programme with a variety of session formats and several hands-on options.

Monday, September 11

The first day of IDEAS opened with a focus course on pending issues in standard EVAR. R. Uberoi opened this EBIR recommend session with a presentation on EVAR in narrow aortic bifurcation, walking attendees through anatomical considerations, threshold size, possible complications, and ways to overcome them. A. Holden continued the session with a talk on sac filling and/or pre-emptive coiling, D. Branzan presented on if all type II endoleaks should be treated, and V. Vermassen rounded out the session with a talk on when to choose IBD vs. bell-bottom limbs in the preservation of hypogastric arteries.

The day continued with sessions focusing on several real-world experiences and examples, firstly through a video learning session, “Aortic interventions – how I do it.” This always popular session format features recorded cases that are presented with live commentary  from the IR performing the procedure. This year’s IDEAS video learning session included two BEVAR cases as well as a sac filling case and a stabilization case. A “My worst endovascular case” case-based discussion rounded out the afternoon, including presentations of and possible solutions for extremely unusual or challenging cases.

A second case-based discussion also took place Monday evening, focusing on EVAR tips and tricks to handle unfavourable anatomy, honing in specifically on issues with access, arch, target vessels, and previous repair.

Monday’s IDEAS expert round table included four presentations on pararenal AAA. P. Vikatmaa defined hostile necks and argued his case for why hostile neck AAA should undergo open repair, including evidence from the 2019’s AAA guidelines and an analysis of the subsequent results since their publication. C. Pena followed up with an often-contrasting presentation outlining why FEVAR should be the first choice in most patients. M. de Haan built upon the previous two presenters’ talks with a lecture outlining the limitations and common contraindications of FEVAR, as well giving options in cases with FEVAR complications. A. Zimmermann deviated slightly for the last presentation, focusing on CHEVAR and his conviction that it should never be used unless there is no other option. This session concluded, as all ERTs do, with an extensive panel discussion based on questions from both the moderators and the audience.

Tuesday, September 12 

The second day of IDEAS started out with an expert round table on TAAA moderated by F. Wolf and M. Jenkins. M. Hamady opened the session with his reasoning why FEVAR/BEVAR should be the first option for most patients with TAAA, defining current indications, rational, and analysing F/BEVAR outcome data. M. Jenkens then spoke on the question of if open repair is still an option in some high-risk patients, N. Dias presented on urgent F/BEVAR endovascular repair, and G. Maleaux closed the lecture portion of the session with a talk on failure of visceral bridging stents in F/BVAR procedures, before an extensive panel discussion began.

The morning progressed with two focus sessions, one on selecting the best option for the arch and another showcasing new devices/techniques/adjuncts in (F/B)-EVAR.

Of-the-moment topics were in the spotlight after lunch. A hot topic symposium on the latest trends in aortic interventions included lectures on risk reduction in SCI, treatment algorithm in short neck, how to overcome extreme access problems, and artificial intelligence in AAA.

This symposium was followed shortly by another expert round table, this time on acute aortic dissection. Treatment algorithms, landing zones, and visceral ischaemia were all presented for consideration before moving to the interactive panel discussion. As always, the expert round tables truly showed the interdisciplinary nature of IDEAS and how only teamwork can lead to optimal patient care.

IDEAS 2023 closed out on a positive note, with a final case-based discussion entitled “Amazing bail-outs in endovascular procedures.”

Hands-on

A six-part IDEAS practical course took place during the event. On Monday, participants were able to use simulation software to acquire practical tips and tricks and learn the principles of sizing and planning for standard EVAR. Tuesday’s lineup included sessions on percutaneous access for large sheaths, IBD, and standard EVAR.