Anastomosis in a live model
End-to-end, end-to-side and side-to-side in rat, with a demonstration before each hands-on session.
21st edition · Since 2006
International Course on Cerebrovascular Microsurgery and Extracranial-Intracranial Bypass
Indications for bypass have narrowed, and with them the opportunities to practise it within one's own department. The course exists so that neurosurgeons reach the operating room having already performed the anastomosis.
Applied Anatomy Laboratory, Autonomous University of Madrid · IdiPaz experimental operating room
21stedition of the courseDirected by Dr. González-Llanos since 2006
5days, 15-19 December 2026In person, in Madrid
20placesIn person, in the laboratory
8speakers at Saturday's symposiumJapan, United States, Chile, Argentina and Spain
Course director
Dr. Francisco González-Llanos
President of the Spanish Society of Neurosurgery (SENEC) and Head of Neurosurgery in Toledo since 2011.
Named on the Forbes list of the 100 best doctors in Spain in 2024, 2025 and 2026, winner of the 2024 Merco-Observatorio de Salud award in neurosurgery, and faculty member of the FEN Sapporo Live Microneurosurgery Course in Japan.
He has directed this course since 2006. During the week he performs four of the laboratory demonstrations himself and, on Saturday, gives his talk on arteriovenous malformations at the symposium.
What you take away
Five days of microvascular technique, from the model to the brain specimen.
Aneurysm clipping
In the swine model, in the IdiPaz experimental operating room, after reviewing general technique and anterior and posterior circulation aneurysms.
The three generations of bypass
From superficial temporal artery to middle cerebral artery bypass to grafts and intracranial-intracranial bypass, with their history and technique.
Models to keep training
Chicken wing, vein microsuturing and arteriovenous fistulas in rat, and anastomosis in brain specimens on Saturday morning.
Who it is for
Practising neurosurgeons and senior residents who will face complex vascular disease: giant aneurysms, occlusive disease and revascularisation.
What is practised
Microsurgical anastomosis under magnification, and low- and high-flow bypass. The course also discusses when bypass is indicated, which graft to use and how to measure flow.
Why a course is needed
Because the learning that the department itself used to provide no longer comes on its own. The course has been held every year since 2006 and is a continuous school of the technique in Spain.
Four stages
How an extracranial-intracranial bypass is performed.
Step 1 of 4
Exposure
Craniotomy, dural opening and dissection of the recipient cortical branch. The donor is prepared to just the right length to reach without tension.
The lab
Each participant sutures at their own microscope station.
Each station has its own vascular training material, and the magnified field on screen makes it possible to follow the manoeuvre stitch by stitch.
The programme, day by day
From Tuesday's theory to Saturday's brain specimen.
Tuesday 15 · afternoonTheory: history of vascular microneurosurgery, aneurysm clipping and the three generations of bypass.See the schedule
- 13:45Course presentation
- 14:00History of vascular microneurosurgery
- 14:30General techniques for clipping aneurysms
- 15:00Anterior circulation aneurysms
- 15:30Posterior circulation aneurysms
- 16:20History and techniques of bypass
- 16:50First-generation bypass: STA-MCA bypass
- 17:20Second-generation bypass: grafts
- 17:50Third-generation bypass: intracranial-intracranial
- 18:30Microneurosurgical training
- 19:00Swine model for aneurysm clipping
- 19:30Rat models for aneurysm clipping
In the 3D Hall of the Autonomous University of Madrid.
Wednesday 16End-to-end and end-to-side anastomosis in rat, and aneurysm clipping in the swine model.See the schedule
- 09:10Demonstration: end-to-end anastomosis in ratLaboratory
- 10:30Hands-on: end-to-end anastomosis in ratLaboratory
- 13:30Demonstration: end-to-side anastomosis in ratLaboratory
- 15:30Hands-on: end-to-side anastomosis in rat and aneurysm clipping in the swine modelLaboratory and IdiPaz OR
- 18:00Cases for discussion3D Hall
Thursday 17Live broadcast case, side-to-side anastomosis and advanced techniques.See the schedule
- 09:10Demonstration by Dr. González-Llanos: side-to-side anastomosis in ratLaboratory
- 10:30Hands-on: side-to-side anastomosis in ratLaboratory
- 13:30Demonstration by Dr. González-Llanos: advanced anastomosis techniquesLaboratory
- 15:30Hands-on: end-to-side and end-to-end anastomosis in rat, and clipping in the swine modelLaboratory and IdiPaz OR
- 18:00Cases for discussion3D Hall
A surgical case is broadcast live during the day.
Friday 18Chicken wing, vein microsuturing and arteriovenous fistulas in rat. In the evening, the course dinner.See the schedule
- 09:10Demonstration by Dr. González-Llanos: preparing the chicken wing modelLaboratory
- 10:30Hands-on: anastomosis in the chicken wing modelLaboratory
- 15:30Demonstration by Dr. González-Llanos: microsuturing veins and creating arteriovenous fistulas in ratLaboratory
- 16:30Hands-on: end-to-side and end-to-end anastomosis in ratLaboratory
- 18:00Cases for discussion3D Hall
- 20:00Bus to the official course dinner
Saturday 19In the morning, anastomosis in brain specimens. In the afternoon, the World Symposium.See the schedule
- 09:10Demonstration: microvascular training in brain specimens (end-to-side, end-to-end and side-to-side)Laboratory
- 10:30Hands-on in brain specimensLaboratory
- 15:00World Symposium on Skull Base and Cerebrovascular Microneurosurgery3D Hall
Invited faculty
Seven neurosurgeons from five countries, and a talk from each of them.
Phoenix, United States
Michael T. Lawton
President and CEO of the Barrow Neurological Institute and chair of its Department of Neurosurgery.
More than 5,400 aneurysms and more than 800 bypasses operated on. AANS Cushing Award in 2023 and author of Seven Aneurysms, Seven AVMs and Seven Bypasses. Co-directs the Barrow's West-East vascular neurosurgery course with Tanikawa.
At the symposium · 18:30Seven AVMs
Sapporo, Japan
Rokuya Tanikawa
Vice President of Sapporo Teishinkai Hospital and director of its Stroke Center.
Co-directs the Barrow's West-East course with Lawton, where he teaches skull base and posterior circulation bypass.
At the symposium · 16:30Surgical treatment of acute ischemia
Sapporo, Japan
Nakao Ota
Neurosurgeon at the Stroke Center and the Far East Neurosurgical Institute of Sapporo Teishinkai Hospital.
Author of nearly a hundred scientific papers, most of them with Tanikawa.
At the symposium · 17:00Following Kamiyama. The art of microvascular neurosurgery
Santiago, Chile
Jorge Mura
Professor at the University of Chile and head of Cerebrovascular and Skull Base Surgery at the Asenjo Neurosurgery Institute.
President of the Chilean Society of Neurosurgery in 2022 and 2023.
At the symposium · 15:30Cavernous sinus as a corridor. MIPLATTA
Buenos Aires, Argentina
Pablo Rubino
Neurosurgeon at Hospital El Cruce and the German Hospital of Buenos Aires.
In 2025 he published a second-generation bypass technique in Operative Neurosurgery.
At the symposium · 17:30Microsurgery of AVMs
Stanford, United States
Maximiliano Núñez
Department of Neurosurgery, Stanford University.
Trained at Hospital El Cruce in Buenos Aires.
At the symposium · 15:00Anatomical study in the lab. The path for imperfection
Palma de Mallorca, Spain
Jon Olabe
Neurosurgeon in Palma de Mallorca.
Co-author of published microsurgical training models: the perfused chicken wing (2009) and the swine aneurysm model (2011).
At the symposium · 16:00Training in neurosurgery. How to become a master
Saturday 19 · 15:00 to 19:00, Madrid time
World Symposium on Skull Base and Cerebrovascular Microneurosurgery
The last afternoon of the course is the symposium. Unlike the course, it can be followed online, it is free and it is open to any neurosurgeon. There are eight talks:
- 15:00Anatomical study in the lab. The path for imperfectionMaximiliano Núñez
- 15:30Cavernous sinus as a corridor. MIPLATTAJorge Mura
- 16:00Training in neurosurgery. How to become a masterJon Olabe
- 16:30Surgical treatment of acute ischemiaRokuya Tanikawa
- 17:00Following Kamiyama. The art of microvascular neurosurgeryNakao Ota
- 17:30Microsurgery of AVMsPablo Rubino
- 18:00Tricks in AVM surgeryFrancisco González-Llanos
- 18:30Seven AVMsMichael T. Lawton
Register for the 21st edition
There are twenty in-person places. Leave your details and continue to the course technical secretariat's registration form.
“The balance between both worlds will not come about by inertia: we must build it. Educating, training, inspiring the new generations, even in a context in which vocations seem more fragile and where technological immediacy can dazzle more than depth of learning.”Dr. Francisco González-Llanos · Anuario iSanidad · May 2026 · translated from Spanish