Come and join us across the globe
The 5th European Stroke Organization Conference opened today in beautiful Milan, Italy.
ESOC 2019 aims to become the leading forum in Stroke care research and it is clearly well on the way having brought together more than 5600 participants from almost 100 countries. This sizable attendance, and the fact that the organization planted over 5000 trees to offset the carbon footprint of such a large and international gathering, earned conference organizer Prof. Jesse Dawson, well-deserved applause.
The meeting began with the “Large clinical trials” program, one the most awaited sessions offering the promise of 11 major clinical trials results: four to be simultaneously published in the Lancet and three in Lancet Neurology.
While some might be disappointed by the overall neutral results that were announced (especially as we hoped to have positive results on the first neuroprotective agent), the extension of the thrombolysis time window and the widespread use of mechanical thrombectomy in developing countries should be seen as major improvements in Stroke care today.
Here’s what we learned today…
The RESCUE BRAIN study evaluated remote ischemic preconditioning at lower limb, which did not show any beneficial effect.
The PASTA trial also came in neutral, no benefit from Paramedic Acute Stroke treatment assessment.
The RATULS trial published, in The Lancet today (May 22nd), did not support the use of robot-assisted training after Stroke.
Unfortunately, the RESTORE trial, which hoped to obtain positive results with a first effective neuroprotective agent, came in negative.
The THAWS trial, surprisingly came in negative too, on the contrary of the WAKE-UP trial. This difference might be explained by the lower rt-PA dose being used here.
This meta-analysis publication , appearing in today’s Lancet demonstrating the efficacy of IV tPA up to 9 hours after onset when perfusion mismatch is depicted. As the speaker concluded, this might offer the possibility of changing clinical practice and extend the thrombolysis time window.
The positive results of the RESILIENT trial by Dr. Raul Nogueira were welcomed with a round of applause.
These results open the way for an increased use of mechanical thrombectomy in developing countries, making this incredible improvement in Stroke management available for thousands of patients throughout the world.
Finally, the ASTER2 Trial, which aimed to demonstrate the superiority of a combined approach (i.e., aspiration + stentriever) for mechanical thrombectomy. What should be applauded in this trial is that it is the first time investigators used TICI2c/3 as a primary endpoint; although a negative subgroup analysis might show superiority when faced with the situation of a T occlusion and large clot burden. Overall, this supports a personalized strategy in each case and offers multiple options to the operator.
The first day has come to an end, but don’t forget tomorrow!
Stay tuned for day 2 and follow our live coverage of #ESOC2019 on Twitter .
Jildaz Caroff
