At the begging of the first day of the ESOC an interesting section was introduced by the Chairs Heinrich Mattle and Valery Feigin on “Extracranial and Intracranial Large Vessel Disease”. The first presentation by Mike Sharma deals with an interesting question on the management of carotid disease: should antiplatelet be combined with anticoagulation in people with carotid disease?

A surprisingly matter was raised by Stefan Engelter on the “safety of sports”! Is sport a common cause of cervical artery dissection? All of us who loves sports may continue to practice it because the association between artery dissection and sport activity is only about 6% and strongly conditioned by age, sex and country habits in having sport activities. Leo Bonati have taken a comprehensive overview on the way towards the selection of people with  asymptomatic stenosis candidate to endoarterectomy or stenting. He highlighted that in asymptomatic patients the two approaches are not different in terms of occurrence of stroke, death or myocardila infarction up 30 days after treatment. Meanwhile, new RCTs are needed to establish the benefits of revascularization for asymptomatic carotid stenosis in the new context of the available medical therapy. Juan Arenillas has reminded us that large arteries may be affected by non- atherosclerotic pathologies and has presented challenging cases of patients affected by vasculitis, arterial dissection and reversible vasoconstriction.