On 12 July 2026, PeerVoice hosted the CE-Accredited symposium “Assessing the Potential of Factor XIa Inhibition for Secondary Stroke Prevention: Supporting Our Cross-Specialty Colleagues in Improving Patient Outcomes” at the ISTH Congress in Paris. As factor XIa (FXIa) inhibitors are being investigated as a potential strategy for secondary stroke prevention, haematologists have an important role in understanding the emerging evidence and its implications for thrombosis, bleeding, and antithrombotic management. The on-demand version of this session is endorsed by ESO and is now available to watch free of charge. To access the program, please click here.

This educational activity explored whether FXIa inhibition could improve prevention of recurrent stroke without increasing bleeding risk. Jeffrey Weitz, MD, OC, FRCP(C); Charlotte Cordonnier, MD, PhD; and Mike Sharma, MD, MSc, FRCPC, discussed the biological rationale, phase 3 evidence, and potential clinical implications of this emerging approach.

Why Target Factor XIa?

Charlotte Cordonnier highlighted the continuing unmet need in secondary stroke prevention. Recurrent stroke remains a substantial risk despite current treatment, while more intensive antithrombotic approaches can increase haemorrhage. FXIa is therefore of interest because it appears to contribute more to pathological thrombosis than to physiological haemostasis, raising the possibility of preventing thrombosis while preserving normal clotting.

Evidence From OCEANIC-STROKE

Mike Sharma reviewed the phase 3 OCEANIC-STROKE trial, which randomised 12,327 patients with recent non-cardioembolic ischaemic stroke or high-risk transient ischaemic attack (TIA) to the investigational FXIa inhibitor asundexian or placebo alongside antiplatelet therapy. Asundexian significantly reduced recurrent ischaemic stroke, with a hazard ratio of 0.74, and effects were consistent across prespecified patient subgroups. Importantly, this benefit was achieved without a significant increase in bleeding.

International Society on Thrombosis and Hemostasis (ISTH) major bleeding occurred in 1.9% of patients receiving asundexian versus 1.7% receiving placebo. Rates of clinically relevant non-major bleeding, intracranial haemorrhage, and minor bleeding were comparable between treatment groups, supporting the hypothesis that selective FXIa inhibition may reduce thrombosis while preserving haemostasis.

Looking Towards Clinical Practice

Jeffrey Weitz led the panel in a discussion that emphasised that any future integration of FXIa inhibitors into practice will require multidisciplinary collaboration, particularly around antithrombotic therapy, bleeding assessment, and peri-procedural management.

The ongoing LIBREXIA-STROKE trial evaluating milvexian will provide further evidence. For now, FXIa inhibitors remain investigational, but the findings discussed during the activity suggest a potentially important new direction for secondary stroke prevention.

Watch on demand

To date, evidence supporting late-window intravenous thrombolysis (IVT) comes from the 2019 individual patient meta-analysis by Campbell et al.¹, which pooled 414 patients. Patients presenting 4.5-9 hours after stroke onset were selected using perfusion imaging demonstrating salvageable brain tissue. IVT showed a benefit (mRS 0-1 at 90 days; aOR 1.86 [1.15-2.99]), despite an increased risk of symptomatic intra-cerebral haemorrhage. However, most patients were treated before endovascular thrombectomy (EVT) became standard practice. Recent randomised trials tried to help define which patients may- or may not- still benefit from IVT beyond the conventional therapeutic window.

LVO – When thrombectomy is available

The TIMELESS² and TNK-PLUS³ trials evaluated late-window IVT in patients with large vessel occlusion (LVO), including M2 occlusions in TIMELESS. Most patients underwent EVT (100% of patients in TNK-PLUS and 77% in TIMELESS). Neither trial demonstrated a functional benefit of IVT administered within 4.5-24 hours after symptom onset. In TIMELESS, IVT did not improve the distribution of functional outcomes (ordinal mRS shift: aOR 1.13, 95% CI [0.82-1.57]), while in TNK-PLUS, there was no significant increase in the proportion of patients achieving mRS 0-2 at 90 days (aRR 1.01, 95% CI [0.83-1.24]). No significant increase in sICH was observed. In both trials, patients were selected using perfusion imaging, and were required to have evidence of salvageable brain tissue with an ischemic core <70 ml.

LVO – When thrombectomy is not available

In settings where EVT is unavailable, the potential role of late-window IVT has also been investigated. The HOPE⁴ and TRACE-III⁵ trials evaluated IVT in patients with proximal vessel occlusion who could not undergo EVT, treating patients within 4.5-24 hours after symptom onset. In both trials, eligibility required evidence of salvageable brain based on perfusion imaging with an ischemic core <70ml. Both studies demonstrated that late-window IVT improved the likelihood of an excellent functional outcome compared with standard medical therapy (TRACE-III RR 1.37 [1.04-1.81]; HOPE aRR 1.52 [1.14-2.02]). The incidence of sICH was numerically higher in the IVT group in both trials, but the difference was statistically significant only in the HOPE trial (aRR 7.34 [1.54-34.84]).

Non-LVO

In contrast, the OPTION trial⁶, focused on patients with non-LVO who were not candidates for EVT. Selected using perfusion imaging (ischemic core volume <50ml with salvageable tissue), IVT administered 4.5-24 hours showed an improved excellent functional outcome (RR 1.28 [95% CI, 1.04-1.57]), although this benefit came at the cost of an increased risk of symptomatic haemorrhagic transformation (RR 2.85 [1.16-5.54]).

Posterior circulation ischemic stroke

Most randomised trials have focused on anterior circulation ischaemic stroke. The TRACE-5⁷ and EXPECTS⁸ trials evaluated IVT in Chinese patients with a posterior circulation stroke (pc-ASPECTS ≥6-7). Both studies reported improved functional outcomes with late-window IVT without increase in sICH. However, the clinical context differed between trials. In EXPECTS, patients considered eligible for EVT were excluded, although 22% of patients had LVO. In contrast, TRACE-5 included patients with basilar artery occlusion, with EVT planned in 56% of patients.

To conclude, IVT beyond 4.5 hours requires highly selected patients, guided by EVT availability, advanced imaging, and vascular territory. Ongoing studies will further define which patients are most likely to benefit and future guidelines will help refine patient selection and treatment strategies.

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1. Kleinig TJ, Fatar M, et al. Extending thrombolysis to 4·5-9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data. Lancet. 2019;394:139–147.
2. Albers GW, Jumaa M, Purdon B, Zaidi SF, Streib C, Shuaib A, Sangha N, Kim M, Froehler MT, Schwartz NE, et al. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. N Engl J Med. 2024;390:701–711.
3. Xiong Y, Che F, Wang H, Hao M, Nguyen TN, Fisher M, Jin A, Cao Z, Wang Z, Yao X, et al. Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke at 4.5 to 24 Hours: The TNK-PLUS Randomized Clinical Trial. JAMA. 2026;335:1849–1858.
4. Zhou Y, He Y, Campbell BCV, Liebeskind DS, Yuan C, Chen H, Zhang Y, Yi T, Luo Z, Zhang Z, et al. Alteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: The HOPE Randomized Clinical Trial. JAMA. 2025;334:788–797.
5. Xiong Y, Campbell BCV, Schwamm LH, Meng X, Jin A, Parsons MW, Fisher M, Jiang Y, Che F, Wang L, et al. Tenecteplase for Ischemic Stroke at 4.5 to 24 Hours without Thrombectomy. N Engl J Med. 2024;391:203–212.
6. Ma G, Mo R, Zuo Y, Ma Q, Zhao G, Yao X, Liang J, Zhou L, He Y, Long F, et al. Tenecteplase for Acute Non-Large Vessel Occlusion 4.5 to 24 Hours After Ischemic Stroke: The OPTION Randomized Clinical Trial. JAMA. 2026;335:1137–1147.
7. Xiong Y, Alemseged F, Cao Z, Schwamm LH, Zhang S, Parsons MW, Fisher M, Hao Y, Jin A, Yin J, et al. Tenecteplase versus standard medical treatment for basilar artery occlusion within 24 h (TRACE-5): a multicentre, prospective, randomised, open-label, blinded-endpoint, superiority, phase 3 trial. Lancet. 2026;407:763–772.
8. Yan S, Zhou Y, Lansberg MG, Liebeskind DS, Yuan C, Yu H, Chen F, Chen H, Zhang B, Mao L, et al. Alteplase for Posterior Circulation Ischemic Stroke at 4.5 to 24 Hours. N Engl J Med. 2025;392:1288–1296.

The ESO EAST Steering Committee organised the 12^th ESO EAST Workshop, with support from the ESO Head Office. The 12th ESO EAST Workshop was held on 5 May 2026 in Maastricht, the Netherlands, traditionally organised a day before the European Stroke Organisation Conference.  It followed the Joint Stroke Action Plan for Europe National Coordinators (SAP-E NC) & ESO EAST Meeting and gathered ESO EAST Country Representatives, the ESO EAST Steering Committee, ANGELS Initiative representatives, the RES-Q team, ESO Head Office representatives, invited guests, and industry partners.

The programme focused on key developments in stroke care across the ESO EAST region, with mainly sessions structured around an introductory presentation followed by country experiences and discussion.

The first session, chaired by Dmytro Lebedynets and Alexandras Vilionskis, addressed mechanical thrombectomy issues in the region, focusing on training and implementation. An introductory presentation by Dmytro Lebedynets, based on the ESO EAST survey, provided an overview of current practices and challenges, followed by country presentations illustrating different stages of development and service organisation.

This was followed by the RES-Q registry session, chaired by Cristina Tiu and Robert Mikulik. Robert Mikulik opened the session with an overview of new developments in the RES-Q registry, with a particular focus on intracerebral hemorrhage (ICH) and quality monitoring. Country contributions highlighted experiences with implementing ICH guidelines in clinical practice.

The session on emerging leaders in stroke, chaired by Alexander Tsiskaridze and Hrvoje Budinčević, presented selected projects reflecting ongoing innovation in the region. Presentations by Marieta Peycheva and Rytis Masiliūnas demonstrated approaches to improving stroke care through digital solutions (virtual hospitals) and national system-level initiatives.

The final session, chaired by Zuzana Gvodinova and Michal Karlinski, focused on neurorehabilitation. Michal Karlinski introduced the session with results from the ESO EAST survey, followed by country presentations addressing current practice and remaining gaps in achieving optimal standards of care in neurorehabilitation.

Discussions were conducted in an amicable, constructive atmosphere, continuing the long-standing tradition of collaboration within the ESO EAST community.

Learn more about ESO EAST

As part of the ESO TF4UKR Department-to-Department Visiting Programme, I had the privilege of completing a ten-day internship at the Stroke Center of Karolinska University Hospital in Stockholm this summer.

First and foremost, I would like to express my heartfelt gratitude to Professor Mazya and his team for the warm welcome, hospitality, patience, enthusiasm, humour, and genuine human attitude — as well as for answering all my questions and for generously sharing their time.

I was deeply impressed by the work of the department — above all, by its logistics, clear division of responsibilities, and system-based organisation. The level of practicality stood out: clear algorithms, tables, and reminders — everything readily available and thoughtfully designed. Workspaces are organised in a way that allows clinicians to be both comfortable and maximally efficient. The technical and material resources are equally impressive — state-of-the-art CT scanners and a cath lab that truly feels like a spacecraft.

Continuous education, meetings, case discussions, team-based decision-making, and multidisciplinary consultations are an integral part of daily routine. The professionalism of the nursing staff is exceptional. However, the most important aspect is how people work. Almost silently. Quickly. Without unnecessary words. Everyone knows their role, performs it precisely, and is able to “read the room”. This approach results in remarkably short door-to-needle and door-to-groin times and, ultimately, better patient outcomes.

I also observed a higher average age of treated patients, milder or well-compensated comorbidities, and a seemingly lower incidence of severe strokes — a reflection of long-terminational investment in primary prevention and the active, healthy lifestyle of the population.

Yes, this is about funding and national health policy. But even more, it is about systems — systems that are built over years, often from within, slowly and sometimes painfully, through difficult and unpopular decisions, persistence, and the courage to defend what is right. And, above all, it is about people — the people who carry these systems every single day. I am deeply grateful to everyone involved in my internship experience for a renewed sense of inspiration to grow, improve, and implement what I have learned in my own clinical practice.

(And to Stockholm as well — a city I truly fell in love with.)

This year’s presidential Symposium Awards and Large Clinical Studies Session, chaired by Götz Thomalla (Hamburg, Germany) and Guillaume Turc (Paris, France), highlighted the expanding horizons of stroke research. After the presentation of ESO Awards, the Honorary Member Awards, the ESO Emerging Leaders and the Angel Awards, seven studies were presented.

Amrou Sarraj presented the results of the individual patient-data meta-analysis on the endovascular treatment (EVT) for large ischemic stroke from the “Analysis of Mechanical Thrombectomy for Large core ischemic Stroke (ATLAS)” collaboration. This meta-analysis included six randomized clinical trials and sought to evaluate the safety and efficacy of EVT versus best medical care among patients with large ischemic core. A total of 944 patients undergoing EVT and 942 receiving medical management were included. ATLAS meta-analysis demonstrates benefit of EVT in wide-spectrum of patients with large core strokes (Number needed to treat – NNT of 4 for improving 1-point or more on modified Rankin Scale – mRS). Consistent improvements were also detected in functional independence, independent ambulation and mortality.

Maarten Uyttenboogaart presented the Carotid Artery Stenting during Endovascular treatment of Stroke (CASES) trial. This is a phase III international multicenter randomized clinical trial with open label treatment and blinded outcome assessment (PROBE) with non-inferiority design, conducted in 26 EVT centers in the Netherlands and Belgium, aiming to investigate if the immediate carotid artery stenting (CAS) during EVT is non-inferior to a deferred treatment strategy for patients with acute ischemic stroke due to tandem lesions. Overall, non-inferiority was not met, since the distribution of mRS scores at 90 days between the two groups did not differ significantly. However, CAS during EVT improved recanalization rates and increased the patency of the carotid artery at 24 hours and 90 days. Moreover, CAS during EVT was safe and did not increase the rate of symptomatic ICH and mortality rate.

 

LATE-MT was presented by Jianmin Kiu. This is a randomized controlled clinical trial aiming to investigate the effectiveness of EVT treatment in the time window of 24-72 hours of onset, in acute ischemic stroke (AIS) patients due to large vessel occlusion (LVO) of the anterior circulation, with an NIHSS score ≥6 points and favorable CT perfusion profile (infarct core volume <50 ml, mismatch ratio ≥1.8 and mismatch volume ≥1.5 ml). The results of this trial showed that EVT in the time window of 24-72 hours after onset improved 90-day functional outcome. However, this resulted in increased mortality and higher rates of symptomatic intracerebral hemorrhage (sICH) compared with standard medical care, suggesting that more selective patient targeting for EVT in the very late time window may yield better outcomes.

The MILD-MT trial aiming to investigate the safety and effectiveness of EVT for patients with mild ischemic stroke caused by acute anterior LVO through perfusion imaging screening was presented by Wenhuo Chen. This multicenter prospective randomized controlled clinical trial, conducted in China, included 144 patients in the group of combined EVT plus best medical management (BMM) and 156 in the group of BMM alone. The trial was positive, achieving the primary efficacy endpoint with higher rates of mRS score 0-1 in the group of EVT+BMM. Moreover, the trial supported the perfusion-based selection of patients with mismatch≥50 ml.

Craig Anderson presented the CRAFT trial, a multicenter, prospective, randomized, open, blinded outcome assessed (PROBE) clinical trial, aiming to determine the safety and effectiveness of more intensive blood pressure (BP) lowering in patients with atrial fibrillation (AF). In this trial each group included 838 patients, who received home BP monitoring to guide treatment. Overall, in patients with AF, the intensive home BP guided strategy (target SBP<120 mmHg) did not reduce major cardiovascular events compared with standard treatment (target SBP<135 mmHg). However, the detected heterogeneity of treatment across prespecified subgroups, with apparent benefits of intensive treatment in males, younger people, and in those on oral anticoagulant suggests an individualized approach to BP-lowering treatment targets in patients with AF.

Elizabeth Lightbody presented the COMMITS trial, a multicenter randomized controlled trial aiming to evaluate the effect of motivational interviewing (MI) compared with Attention Control (AC) and Usual Care (UC) on depressive symptoms post-stroke. A total of 1246 consecutive adult acute stroke patients across 18 sites were included. Motivational Interviewing was associated with a small but consistent reduction in depressive symptoms, without any significant functional, quality-of-life, or economic benefit. These effects were observed in a predominantly mild stroke population with low baseline psychological morbidity.

Jeffrey Saver presented the DISTALS trial, evaluating the safety and effectiveness of the Tigertriever 13 Revascularization Device in restoring blood flow in the neurovasculature in patients presenting within 24 hours of onset with an ischemic stroke with disabling neurological deficits due to a primary distal vessel occlusion (DMVO). This was a multicenter, prospective, randomized, blinded (endpoint), controlled study, conducted in 25 centers in US and Europe. Rates of sustained reperfusion at 24h were significantly higher, whereas no symptomatic ICH occurred in the EVT group using Tigertriever 13.

The second Large Clinical Trial session delivered compelling new evidence across a broad spectrum of topics, including primary prevention, acute stroke management, reperfusion therapy, and post-stroke care, leaving the audience of more than 4,000 participants eager for the upcoming sessions of the 12th European Stroke Organisation Conference 2026 in Maastricht.

The closing session of ESOC 2026, chaired by Urs Fischer and Else Sandset, concluded three days of high-level scientific exchange in Maastricht with the presentation of ESOC awards and a series of major late-breaking clinical trial results spanning acute stroke treatment, secondary prevention, cerebral venous thrombosis, and stroke imaging.

Craig Anderson presented secondary cognitive and imaging outcomes from the TRIDENT trial, a multinational, double-blind, placebo-controlled trial of a triple low-dose antihypertensive pill after intracerebral haemorrhage, recently published in the New England Journal of Medicine. Over a mean follow-up of 3 years, no significant difference was observed between the triple-pill and placebo groups in cognitive outcomes or MRI markers of cerebral small vessel disease, suggesting that longer follow-up or larger dedicated studies may be needed to detect potential cognitive benefits of sustained blood pressure lowering after ICH.

Mikael Mazighi presented the GREEN trial, evaluating intravenous glenzocimab as an adjunct to mechanical thrombectomy in large vessel occlusion stroke. The trial was terminated early for futility after enrolling 102 patients, with no benefit on the 90-day mRS ordinal shift and a numerical trend toward worse outcomes in the treatment arm.

The GALLOP-2 trial, presented by Hao Wang and Yiu Ming Bonaventure Ip, evaluated short-course adjunctive semaglutide in patients with anterior circulation large vessel occlusion treated with endovascular thrombectomy without prior thrombolysis. Semaglutide was associated with improved 90-day functional outcomes and a favourable mRS distribution shift compared with standard therapy, supporting further investigation of GLP-1 receptor agonists as neuroprotective agents in acute ischaemic stroke.

Diana Aguiar de Sousa presented the 24-month results of the EXCOA-CVT cluster-randomised trial, conducted across 43 centres in 21 countries, comparing 3–6 versus 12 months of anticoagulation after cerebral venous thrombosis. Consistent with the 12-month results, no evidence emerged that prolonging anticoagulation provides additional clinical benefit, supporting an individualised approach to treatment duration in clinical practice.

Marios Psychogios presented the SPINNERS trial, a multicentre non-inferiority study evaluating syngo DynaCT Sine Spin flat-detector CT versus multi-detector CT for intracranial haemorrhage detection in 251 stroke patients across 13 hospitals. Overall non-inferiority was not met, but sensitivity exceeded 96% in patients with NIHSS ≥10 and in high-volume centres, suggesting a potential role for FDCT in One-Stop Management and Direct-to-Angio workflows in selected patients.

Yilong Wang presented the TAPIS trial, simultaneously published in The Lancet, a double-blind, placebo-controlled trial of early ticagrelor-aspirin dual antiplatelet therapy combined with intravenous thrombolysis in 1,382 patients with moderate ischaemic stroke across 60 hospitals in China. Early DAPT significantly improved the rate of excellent functional outcome at 90 days (68.7% vs 62.0%; RR 1.11; p=0.0089) without a meaningful increase in symptomatic intracranial haemorrhage, representing an important advance in acute stroke care pending validation in broader populations.

Guoyong Zeng and Jeffrey L. Saver presented the INSTANT trial, simultaneously published in JAMA, evaluating intravenous tirofiban after tenecteplase in 359 patients with acute ischaemic stroke without large vessel occlusion who had an insufficient clinical response to thrombolysis. The unadjusted primary outcome favoured tirofiban (mRS 0–1: 63.8% vs 52.2%; p=0.03), though the adjusted analysis did not reach significance, and tirofiban did not increase haemorrhagic risk, suggesting a promising rescue strategy warranting confirmation in larger trials.

Xiang Luo presented the ATTRACTION trial, evaluating adjunct tirofiban after successful endovascular recanalization in 1,380 patients with anterior circulation large vessel occlusion stroke across 82 centres in China. Tirofiban significantly improved functional independence at 90 days (49.3% vs 43.3%; adjusted RR 1.15; p=0.009) without a significant increase in symptomatic intracranial haemorrhage or mortality, though external validation in broader international populations is warranted.

Elena Zapata-Arriaza presented the ATILA trial, a Spanish multicentre randomised trial comparing low-dose intravenous tirofiban versus intravenous aspirin as periprocedural antiplatelet therapy in 240 patients with tandem lesion stroke undergoing mechanical thrombectomy plus emergent carotid stenting. Tirofiban significantly reduced acute in-stent reocclusion at 24 hours (7.2% vs 16.8%; aOR 0.345; p=0.015) and intra-stent aggregation, without a statistically significant increase in symptomatic intracranial haemorrhage, supporting its use in this challenging and underrepresented patient population.

The closing session of ESOC 2026 delivered an exceptional and rich programme of late-breaking results, reflecting the breadth of global stroke research. The convergence of positive findings from TAPIS, ATTRACTION, INSTANT, and ATILA – all pointing toward early antiplatelet strategies in selected populations – alongside the nuanced results of SPINNERS and GALLOP-2, underscores the importance of patient selection and treatment context. ESOC 2026 concluded with a shared commitment to advancing stroke care through rigorous science and international collaboration.

Walking through the poster exhibition at the 12th European Stroke Organisation Conference in Maastricht was an exciting experience. Here are four studies that stopped me in my tracks.

Air pollution and stroke outcomes

Fiona Huber and colleagues tackled a cutting-edge topic with their poster, “LONG-TERM EXPOSURE TO AIR POLLUTION (PM2.5 AND NO2) AND ITS ASSOCIATION WITH CLINICAL OUTCOMES AFTER ACUTE ISCHAEMIC STROKE.” Air pollution is an established stroke risk factor, and this Swiss research group examined its impact on 1,446 acute ischaemic stroke patients hospitalised between 2015 and 2022. Average annual exposure to PM2.5 and NO2 was estimated using geocoded residential addresses. Higher PM2.5 exposure was associated with greater stroke severity at admission (higher median NIHSS, p=0.008), more cardioembolic aetiology (p<0.001), and more ICA/MCA tandem occlusions (p<0.001). Interestingly, patients with higher PM2.5 exposure also presented with shorter prehospital delays, longer acute care stays, fewer EVT complications, and better adjusted 3-month functional recovery (mRS 0–2: OR 1.052; 95% CI: 1.001–1.106). Higher NO2 exposure, by contrast, was linked to poorer excellent outcomes (mRS 0–1: OR 0.975; 95% CI: 0.951–1.000) and more recurrent strokes (p=0.005). These findings reinforce the need for greater awareness, among patients, clinicians, and researchers alike, of how air quality affects both stroke risk and recovery, including countries with potentially lower pollution exposure levels.

Sexual health after stroke

Monica Serrano and her Spanish colleagues drew attention to an often-overlooked post-stroke deficit with their poster, “SEXUAL HEALTH IMPAIRMENT AMONG POST-STROKE PATIENTS: AN OBSERVATIONAL STUDY.” From a prospective cohort of up to 340 eligible patients, 35 were ultimately included. Participants were contacted six months after their stroke to assess sexual activity, function, and body image, and to explore links with mood and quality of life. Before the stroke, 91.4% reported a satisfactory sex life; afterwards, 71% resumed sexual activity. No significant differences between sexes were found in mRS scores, quality of life, or depression and anxiety prevalence. However, nearly half of participants (48.6%) reported sexual dysfunction, with women more affected than men. The low response rate (10.9%) underscores the sensitivity of this topic, and the impressive high prevalence of this deficit highlights the urgent need for tailored assessment tools and counselling services within stroke care pathways.

Ultrasound in the hybrid Mobile Stroke Unit

Radim Licenik and colleagues presented an innovative contribution from the pre-hospital setting: “USE OF POINT-OF-CARE AND INTERVENTIONAL ULTRASOUND MODULES DEVELOPED FOR HYBRID MOBILE STROKE UNITS.” Hybrid Mobile Stroke Units (h-MSUs) are specialised ambulances designed to respond not only to stroke but to a broader range of neurological emergencies. Equipped with mobile CT scanners, ultrasound, X-ray, ECG, EEG, and advanced point-of-care laboratory equipment, they can deliver neurointensive care in pre-hospital settings. The Czech MSU team, in collaboration with the World Organisation of Neurosonology POCUS/FoCUS working group, developed a multimodule POCUS programme applicable across healthcare settings. The MSU-POCUS module integrates cardiac, medical, neurological, vascular, and interventional modalities, and was deployed during a trial in the Zlín-Valmez region of Czechia from October to December 2023. The results confirm that MSU-POCUS is a feasible, safe, and efficient tool that adds meaningful diagnostic capability to standard pre-hospital care.

Sex and socioeconomic disparities among stroke patients in Tanzania

Finally, Joshua Ngimbwa from Tanzania passionately presented compelling work with the e-poster “SEX AND SOCIOECONOMIC DIFFERENCES IN RISK FACTORS, CLINICAL PRESENTATION, AND THIRTY-DAY OUTCOMES OF STROKE PATIENTS AT TERTIARY HOSPITALS IN TANZANIA.” Low- and middle-income countries largely contribute to the global stroke burden in terms of incidence, mortality, and disability-adjusted life years (DALYs). While sex differences and socioeconomic status are well-documented determinants of stroke outcomes in high-income settings, evidence from Tanzania remains limited and inconsistent, despite recent national efforts to establish stroke units and a stroke registry. This ongoing multicentre prospective cohort study aims to evaluate sex- and socioeconomic-related differences in vascular risk factors, clinical presentation, and 30-day outcomes among adults admitted with neuroimaging-confirmed stroke to three major tertiary hospitals. Socioeconomic status is measured using a standardised composite index adapted from the Demographic and Health Survey wealth scale, with a target sample of 630 participants over one year. This work has the potential to inform more equitable, context-specific stroke care strategies in sub-Saharan Africa, and we look forward to seeing the final results.