From detection to rehabilitation, the field of stroke treatment is vast, and each step critical. Join Prof. Tudor G. JOVIN at the recent LINNC Paris 2021 as he offers his personal insights into the present and future of stroke management.
Questioning whether the pendulum could be swinging away from new devices towards intravenous drug use, Prof. JOVIN discusses current trends in the field of thrombectomies including adjunctive therapies. A series of trials have so far been inconclusive as to whether we should “forgo giving intravenous tPA or TNK” in patients with large vessel occlusions, but could there still be a benefit? What about subgroups where this approach might be indicated? Speaking about lytics, Prof. JOVIN points out that as we give them at the end of a case – we know tPA works for smaller vessels – would it make sense to give them before mechanical thrombectomy as well?
Clearly the “big picture” though is what has been accomplished with the existing procedure. Twenty years ago, Prof. JOVIN reminds us, there were only lytics and a procedure would take 5 hours. Today, we can consistently re-open vessels in a half an hour to 45 minutes, but where do we go next?
What are today’s challenges and, more importantly, how do we respond and achieve better outcomes?
How much better can we get? Or, as Prof. JOVIN asks, are we reaching a plateau in terms of true gains?
We still face the logistical challenge in streamlining the whole stroke care process from detection to getting the patient to the hospital to the initiation of the intervention itself.
How do we simplify and speed up the process? Less imaging? Less intermediate steps and medical specialists? Prof. JOVIN discusses the ANGIOCAT trial which demonstrated significant benefit when patients go directly to the angiosuite.
Finally, what does the future hold in stroke treatment?
Will we have wearable devices that can predict stroke?
What about new approaches to neuro-recovery such as computer brain interface, neuro-stimulation or virtual reality enhanced physical therapy?
To learn more about these and other exciting points in stroke treatment, tune in now and hear what Prof. Tudor G. JOVIN has to say…