Ateneo - UPO

The course covers angiographic techniques applied to diagnostic and interventional neuroradiology, focusing specifically on the technological, procedural, and professional aspects within the scope of practice of the Medical Radiology Technician (TSRM).
Topics will include the operating principles of angiography equipment, image acquisition and post-processing techniques, patient and angiography suite preparation, key devices and materials used, and the endovascular procedures of greatest significance in neuroradiology.
Particular emphasis will be placed on image quality, dose optimization, radiation protection for patients and staff, and the role of the TSRM within the interventional neuroradiology team.

Teaching materials and presentations provided by the instructor.
Guidelines and recommendations from leading national and international scientific societies in the fields of interventional neuroradiology, interventional radiology, and radiation protection.
Technical and scientific documentation regarding the equipment, acquisition systems, and devices used in angiographic procedures. (Passariello)

The course aims to provide students with the theoretical and technical-practical knowledge necessary to understand and participate—within the scope of the Medical Radiology Technician's (TSRM) professional competencies—in the main diagnostic and interventional angiographic procedures in neuroradiology.
By the end of the course, students must be familiar with the characteristics of angiographic equipment, image acquisition and post-processing methods, the primary materials and devices used in endovascular procedures, and the procedures for preparing and managing the angiography suite.
Students must also be familiar with the principles of radiation protection and dose optimization, and understand the role of the Medical Radiology Technician within the multi-professional team.

Basic knowledge is required regarding the anatomy—including radiological and vascular anatomy—of the craniocerebral and spinal regions, the physics of ionizing radiation, radiological image formation, contrast media, and principles of radiation protection.
General knowledge concerning digital radiological equipment and image processing techniques is also beneficial.

Teaching activities will be conducted through lectures supported by multimedia presentations, angiographic images, videos, and demonstrations of key interventional procedures.
Examples of diagnostic and therapeutic procedures will be presented, with a particular focus on image acquisition techniques, the use of equipment and devices, the technical management of procedures, and radiation protection.
Discussions of clinical-technical cases will be used to bridge the gap between theoretical knowledge and professional practice.

Teaching materials used during classes may be made available to students via the University’s official channels.
The topics covered during classes form an integral part of the exam syllabus.
Any images, videos, and case studies used for teaching purposes will be presented in compliance with data privacy regulations.

Student learning will be assessed via an oral examination as part of the integrated course exam.
The exam aims to verify knowledge of diagnostic and interventional angiographic techniques in neuroradiology, as well as the equipment, materials, and devices used.
Students will be evaluated on their ability to describe the various stages of an angiographic procedure—from room and patient preparation to image acquisition and post-processing—while identifying appropriate strategies to ensure adequate image quality and minimize exposure to ionizing radiation.
Assessment criteria will include the accuracy and completeness of knowledge, the ability to connect different topics, the appropriate use of technical-scientific terminology, and the capacity to apply acquired knowledge to professional situations.

Introduction to Interventional Neuroradiology
Organization of the angiography suite and the multidisciplinary team. Role and competencies of the radiographer (TSRM) in diagnostic and interventional procedures. Room and patient preparation.
Angiographic equipment
Operating principles of the angiography system. Monoplane and biplane systems. Image formation chain. Fluoroscopy and angiographic acquisition. Technical acquisition parameters.
Image acquisition and processing techniques
Digital Subtraction Angiography (DSA). Angiographic acquisitions in various projections. Roadmapping. Subtraction techniques. Rotational acquisitions and 3D reconstructions. Cone Beam CT and key applications in interventional neuroradiology. Image post-processing.
Angiographic anatomy
Key vascular anatomy of the supra-aortic trunks and intracranial circulation. Carotid and vertebrobasilar circulation. Main angiographic projections used for cerebral vessel imaging. Overview of spinal vasculature.
Diagnostic angiography
Technical principles of cerebral and spinal angiography. Patient preparation and positioning. Contrast media and automatic injection systems. Image acquisition and main projections. Technical management of the procedure.
Materials and devices
Key materials used in endovascular procedures: introducer sheaths, diagnostic catheters, guiding catheters, microcatheters, guidewires, and microwires.
Principles and characteristics of key therapeutic devices: stents, stent retrievers, aspiration systems, coils, flow diverters, and embolic agents.
Interventional neuroradiology procedures
Technical principles of key endovascular procedures:
● mechanical thrombectomy for acute ischemic stroke;
● endovascular treatment of cerebral aneurysms;
● embolization of arteriovenous malformations and arteriovenous fistulas;
● angioplasty and stenting procedures;
● overview of spinal endovascular procedures.
For each procedure, the following aspects will be analyzed: the patient pathway, room preparation, equipment, materials, image acquisition techniques, and the role of the medical imaging technologist (TSRM).
Radiation protection and optimization
Radiation protection principles applied to interventional neuroradiology. Patient and staff exposure. Individual and collective protective equipment. Technical parameters influencing dose.
Strategies for optimizing exposure during fluoroscopy and angiographic acquisition. Dosimetric indicators and dose monitoring in interventional procedures.
Quality and safety
Angiographic image quality. Main artifacts and their correction. Optimization of acquisition protocols.
Technical management of urgent and critically ill patients. Staff safety and room organization during complex proc

Knowledge and understanding
By the end of the course, the student must be familiar with the operating principles of angiographic equipment, image acquisition and post-processing techniques, and the main materials and devices used in diagnostic and interventional neuroradiology.
They must be familiar with the main endovascular procedures and understand their various technical and operational phases.
Ability to apply knowledge and understanding
The student must be able to apply the knowledge acquired to the technical preparation and management of an angiographic procedure, identifying the most appropriate acquisition and post-processing methods.
They must understand the function of the main materials and devices used in endovascular procedures.
Making judgments
The student must be able to evaluate the technical quality of angiographic images and identify key strategies for optimizing acquisition and radiation dose, within the scope of the medical radiology technician's (TSRM) professional competencies.
Communication skills
The student must correctly use the technical-scientific terminology specific to interventional neuroradiology and understand the communication and collaboration dynamics within the multi-professional team.
Learning skills
The student must acquire the tools necessary to independently deepen and update their knowledge regarding the evolution of angiographic technologies, endovascular devices, and interventional neuroradiology procedures.