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Research. Case Reviews.
Shared Knowledge

From peer-reviewed studies to behind-the-scenes insights from our tri-city rounds, this is where BLT shares what we’re learning—and what’s next in pediatric neurovascular care.

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BLT Toronto Meeting – March 21, 2024: Case Studies, Debates, and Research Directions

Updated: Aug 28

On Thursday, March 21, 2024, members of the Boston–London–Toronto (BLT) Consortium convened in Toronto for a full day of case presentations, scientific discussions, and collaborative debates in pediatric neurovascular care. The meeting was hosted by Dr. Peter Dirks and Dr. Prakash Muthusami, who welcomed participants and opened the day with group introductions and photos.


BLT Toronto Meeting 2024 – pediatric neurovascular collaboration and research discussions
BLT Toronto Meeting 2024 – pediatric neurovascular collaboration and research discussions

Session 1: Case Presentations


The morning began with case studies from each center, fostering dialogue on complex neurovascular challenges:

  • SickKids (Toronto): Two cases of flow diversion for aneurysm, presented by Dr. Carmen.

  • Great Ormond Street Hospital (London): Shared unique cases for group discussion.

  • Boston Children’s Hospital (Harvard): Presented complex clinical cases from their program.


This session allowed members to compare approaches and highlight emerging techniques in pediatric aneurysm management.


Session 2: Vascular Biology & Basic Science


The consortium then turned to the biological underpinnings of vascular disease:

  • Dr. Brent Derry presented on the clinical experience with MEKi in extracranial AVM, exploring novel therapeutic directions.

  • Jason Fish and Jack Brzezinski contributed additional perspectives on vascular biology and translational science.This segment emphasized the importance of bridging laboratory findings with clinical applications.


Session 3: Stroke & Clots


Critical discussions on stroke management in children followed:

  • Dr. Samyami Chowdhury (SickKids) addressed CSVT in children and whether it’s time to expand endovascular therapy (EVT) in this population.

  • Dr. Laura Lehman (Boston Children’s) compared Suzuki grading using catheter angiography vs. MRA and diffusion MRI for evaluating asymptomatic vs. symptomatic Moyamoya.

  • Dr. Leo Brandao (SickKids) spoke on DAP management for intracranial stents, offering practical strategies for patient safety.


Session 4: Controversies & Debates


The afternoon featured spirited debates on challenging treatment strategies:

  • Dr. Soliman Oushy (Boston Children’s) reviewed surgical techniques for completion treatment of residual Vein of Galen Malformations (VGAM).

  • Dr. Adam Rennie (GOSH) discussed radiosurgical approaches for residual VGAM.

  • Dr. Pascal Mosimann (UHN) presented on endovascular downstaging of inoperable AVMs, highlighting evolving minimally invasive interventions.


This format encouraged open dialogue on differing philosophies of care, pushing the consortium toward unified frameworks.



Wrap-Up & Research Brainstorming


The day concluded with an open forum led by Dr. Dirks and Dr. Muthusami, where participants brainstormed future research directions and collaborative studies.

Following the meeting, members continued discussions during an evening networking event at SPIN Toronto, strengthening partnerships across institutions.


Key Takeaways

  • Case-based learning remains a cornerstone of BLT collaboration, offering real-world perspectives.

  • Novel approaches in AVM, VGAM, and Moyamoya are advancing both surgically and non-surgically.

  • Expanding research in vascular biology and pediatric stroke is critical for the next generation of treatment.


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