ESOC 2019: Joint ESO-ESMINT Endovascular Stroke Treatment Session

On May 22, from 16:45-18:15, in the Gold Room, the Joint ESO-ESMINT Endovascular Stroke Treatment Session – took place, chaired by Sònia Abilleira (Spain) and Patrick Brouwer (Sweden).

The first speaker was Phil White (United Kingdom) who asked DO WE STILL NEED A RANDOMISED CONTROLLED TRIAL FOR POSTERIOR CIRCULATION STROKE? The take home points were that we need reliable RTC data to assess what further trials may be warranted in posterior circulation stroke (milder NIHSS, longer time than 6h to MT) and advanced brain imaging.

Pasquale Mordasini (Switzerland) talked about TREATMENT OF TANDEM OCCLUSION: EVIDENCE AND CONSIDERATIONS ON ANTI-AGGREGATION. He concluded that MT in tandem occlusion seems to have the same treatment effect as isolated large vessel occlusion; overall stenting of the cervical ICA in the acute setting of stroke seems not to reduce the positive treatment effect; non-aggressive antiplatelet regime (ASA) seems to be a reasonable trade-off between risk of sICH and stent occlusion and decision to stent should be based on individual patient selection (e.g. lesion etiology/morphology, residual adherent thrombus, hemodynamic impairment, NIHSS/infarct size, diabetes) and stents / techniques used (as non-thrombogenic as possible). The take home message was that most recent evidences support equivalence between aspiration and stent retrievers, and that there is still no evidence that combined approaches do better.

Mikael Mazighi (France) asked ASPIRATION THROMBECTOMY FIRST?  Carlos Molina (Spain) talked about FAST-TRACK TO INTERVENTION: SKIP EMERGENCY AND IMAGING with useful advise and Dejana Jovanovic (Serbia) gave an excellent and detailed overview in her lecture on the topic WHAT ARE THE REQUIREMENTS FOR ENDOVASCULAR THERAPY ACROSS EUROPE?