Come and join us across the globe
The second day of the European Stroke organization conference began with less drama than the first day which saw all the breaking trials, but it did feature a variety of research and clinical experience of great interest to the community.
Stroke is a devastating disease that will unfortunately affect more and more people in the years to come. During the Presidential symposium, a NIHR research from Kings College highlighted a projection of 3% more stroke incidence in Europe over the next 30 years with a 17% reduction of mortality. Stroke survivors will increase by 27%, emphasizing the need for more rehabilitation and post stroke care structures.
The HERMES group showed (from the 7 RCTs) that the selection by collateral or perfusion imaging resulted in better clinical outcomes. Although the key message to keep in mind is that EVT was superior to control regardless of the imaging selection method.
Extending the window for reperfusion therapy – Do we need perfusion imaging? This was the theme of the “controversy in Stroke” session. On one side of the debate we had the very confident Dr H. Ma, thanks to his publication yesterday in the Lancet , which demonstrated the benefit of IV rt-PA after 4.5 hours through perfusion imaging selection.
Dr G. Thomalla, the challenger, made great points with the audience poll. Perfusion parameters can be confusing, even in an expert neurologist audience, and I was amazed to see that nearly half of the people were not aware of which parameter they are using to define the ischemic core. Dr Thomella concluded that you might not need perfusion if you use MRI.
The afternoon was witness to a great ESO-ESNR joint session. In his talk, Mayank Goyal, i.e., a stroke Rockstar, might have killed the debate. He recommended that “the patient is having a very bad day, forget perfusion and collaterals! Make it simple, if there is an LVO go and get the vessel open!!!”.
This second day at ESOC 2019 was really filled with inspiring talks and discussion.
Stay tuned for Day 3, when we will talk about first pass effect, AI and more!
And don’t forget to follow our live coverage of #ESOC2019 on Twitter .
Jildaz Caroff
