CIRSE Fellowship report: Dr. Dejan Taneski

By Dr. Dejan Taneski

My CIRSE Fellowship in the Neuroradiological Clinic at Klinikum Stuttgart, under the mentorship of Prof. Dr. Hans Henkes, was a truly unforgettable and transformative experience. Coming from a smaller country and an institution where we strive to cover nearly the full interventional radiology spectrum, I have always been especially drawn to neuroradiological procedures. For me, there could hardly have been a better choice than this renowned centre, known across Europe for its outstanding neurointerventional expertise, research, and high procedural volume.

From right to left: Prof. Henkes, me, Dr. Hajiyev, Dr. Khanafer

Objectives and expectations

My main objectives when applying for this fellowship were to:

1. Gain hands-on exposure to a centre dedicated exclusively to neurovascular procedures.
2. Observe a high-volume workflow and understand the organization of such a complex department.
3. Compare the setup, workflow, and multidisciplinary communication with my home institution.
4. Learn specific procedural techniques and pre/post-procedural management approaches that could be adapted back home.

I am pleased to say that these expectations were fully met and even exceeded.

The experience and workflow

During my one-month stay, the department performed over 100 neurovascular interventional procedures and more than 150 diagnostic brain digital subtraction angiographies (DSAs). This impressive caseload covered the entire spectrum of brain vascular pathology, from simple aneurysm coiling to the most complex arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs).

I was able to actively participate in many of these cases, assisting in the angio suite, observing different device choices, and learning subtle but crucial details about technique and patient selection. The environment was both demanding and inspiring—every procedure was meticulously planned, with clear communication between all team members.

The clinic’s workflow was particularly impressive. Each day began with a concise morning briefing, where all ongoing cases were reviewed and responsibilities were distributed. Cases flowed smoothly thanks to excellent coordination between neuroradiologists, anaesthesiologists, nurses, and technicians. Even with a high procedural volume, everything was done in a calm, structured, and precise manner.

Learning from the mentor and the team

A true highlight of my stay was learning directly from Prof. Henkes. Observing his approach to complex neurovascular cases was invaluable. Beyond the technical mastery, what struck me most was his patient-centered mindset. Each consultation was a lesson in communication. He always took the time to explain every step of the procedure, the potential risks, and the expected outcomes in a way that patients and their families could understand.

I also had the privilege of learning from Dr. Ali Khanafer and Dr. Kamran Hajiyev, whose guidance and support made a significant impact throughout my stay. They, along with Prof. Henkes, were always available for questions and discussions, no matter how busy the day was. Their openness to share knowledge and analyze cases in depth helped me understand the decision-making process behind each treatment strategy. These daily exchanges were among the most enriching parts of the fellowship and contributed greatly to my professional development.

The F building of Klinikum Stuttgart where the Neuroradiological Clinic is located

Interdisciplinary collaboration

Another remarkable aspect of the Klinikum Stuttgart experience was the seamless collaboration between the neuroradiology, neurology, and neurosurgery departments. Complex cases were always discussed interdisciplinary, ensuring that each patient received the most appropriate and individualized treatment. This open exchange of ideas between specialties was not only efficient but also created a highly stimulating academic atmosphere. Observing how this integration worked in a large tertiary centre has given me valuable insights into how to strengthen cooperation within my own department and improve patient care pathways.

Clinical and educational aspects

Besides the technical exposure, the fellowship also deepened my understanding of the clinical aspects of neurointervention. I had the opportunity to follow patients from their initial imaging and diagnostic phase, through the interventional treatment, and into their post-procedural recovery. This continuity of care helped me appreciate the importance of pre-procedural planning, patient selection, and follow-up protocols.

Furthermore, I was encouraged to participate in teaching sessions and internal case discussions. These sessions covered not only procedural reviews but also literature updates and case complications. Emphasis on continuous education is a core part of the department’s culture.

In action with Dr. Hajiyev

Differences and takeaways

Comparing my home centre with Klinikum Stuttgart, the Stuttgart team benefits from having a fully dedicated neurointerventional setup, including multiple angiography suites, specialized nursing staff, and on-site access to all necessary devices. Despite these advantages, I found that many of their best practices—especially those related to communication, preparation, and case review—can be adopted regardless of available resources.

The most important lessons I am bringing back home are:
• The value of structured daily planning and pre-procedural briefings.
• The benefit of multidisciplinary case discussions in optimizing treatment strategies.
• The importance of maintaining calm, focused teamwork even during complex or emergency procedures.
• The necessity of thorough patient communication and informed consent as a cornerstone of good medical practice.

Among many memorable moments, assisting in complex aneurysm coiling and AVM embolization procedures were definite highlights. Observing the use of advanced devices such as flow diverters and liquid embolics was particularly educational. Being able to discuss these techniques directly with Prof. Henkes and his team gave me deeper insights into the reasoning behind device selection and deployment strategies.

Conclusion

This fellowship has been one of the most rewarding professional experiences of my career. It expanded my technical knowledge, strengthened my clinical understanding, and reshaped my vision for future practice. I am sincerely grateful to Prof. Henkes, Dr. Khanafer, and Dr. Hajiyev for their exceptional mentorship, patience, and constant encouragement. Finally, I wish to express my deepest gratitude to CIRSE for providing this unique opportunity. The insights, friendships, and experiences gained during this fellowship will have a lasting impact on my professional growth and my commitment to advancing neurointerventional care in my home country.