ESOC 2026 Poster Walk, Day 1 by Alexandra Maury

On this opening day of ESOC 2026 in Maastricht, the poster hall was alive with energy, showcasing an impressive array of studies presented by participants from a wide range of countries. I had the privilege of kicking off the poster walk and would like to highlight a few posters that especially drew my attention.

Among the posters addressing acute ischemic stroke management, I would like to highlight “EVT in patients with tandem lesions: effect of CAS and EVT DEVICES, a cohort study from the EVA-TRISP collaboration” by Theodora Van Elk et al. EVA-TRISP is an international multicenter cohort enrolling consecutive patients with acute ischemic stroke patients. One of the objectives of this study was to compare outcomes in tandem lesions patients treated with and without CAS during EVT. The study included adult patients with anterior circulation LVO and concomitant stenosis >50% or occlusion of extracranial carotid artery. Among 13,702 patients, 1,545 (11.3%) presented with tandem lesions. Of these, 596 (39%) underwent CAS during EVT, while 949 (61%) did not. The good functional outcome (mRS 0-2) was achieved in 47% of patients in the CAS group compared with 37% in the non-CAS group (OR 1.33 [1.04-1.70]. They were no significant differences between groups in terms of complete recanalization (71% vs 70%), sICH (5.4% and 6.0%) and mortality (27% vs 19% OR 0.75 [0.56 – 1.00]).

Turning to intracranial hemorrhage, I would like to present the study by S. Fandler-Höfler et al. “Long-term outcome of patients with iatrogenic cerebral amyloid angiopathy”. This multicenter analysis included patients from four European countries who fulfilled criteria for possible or probable iatrogenic cerebral amyloid angiopathy (iCAA). In total, 83 patients were enrolled, with a median age of 50 years at presentation. At onset, clinical manifestations were dominated by ICH (50%) and cortical subarachnoid hemorrhage (32.9%). The median follow-up duration was 3.8 years. Over this period, 74 symptomatic ICH were observed, corresponding to an incidence rate of 19.2 per 100 patient-year after the initial event. Interestingly, despite this high hemorrhagic event, the mortality was 7.3%

Lucio D’Anna et al. from London reported “Continuation versus switching direct oral anticoagulant after breakthrough stroke: a non-inferiority target trial analysis from the ASPERA-R study”. In this multicenter, registry-based cohort study, the authors compared post-stroke anticoagulation strategies in patients with atrial fibrillation who experienced an ischemic stroke despite ongoing direct oral anticoagulant (DOAC) therapy. The analysis included 1,006 patients from 35 stroke centers, of whom 543 (54%) were switched to a different oral anticoagulant. Rates of recurrent ischemic stroke were similar between patients who continued their initial DOAC and those who switched therapy (2.9% vs. 3.1%), as were the rates of symptomatic intracranial hemorrhage (0.9% vs. 1.2%). These results suggest do not support a systematic strategy of switching anticoagulant therapy after a breakthrough stroke.

Within the Diagnosis and Etiology section, one poster that drew my attention was “Detection of Cardiac Thrombi by CT in Patients with Transient Ischaemic Attack” by Shuyu Guo et al., on behalf of the AIS of HEARTS registry, a collaboration between four comprehensive stroke centers in the Netherlands. The study aimed to determine the prevalence of cardiac thrombi detected by cardiac CT in patients with transient ischemic attack (TIA), in comparison with those presenting with acute ischemic stroke (AIS). The analysis included 313 patients with TIA and 3,919 with AIS. The median ABCD2 score among TIA patients was 5.

Cardiac thrombi were identified in 1.3% of TIA patients (n=4), compared with 6.2% of AIS patients (n=243). Among TIA patients with a detected thrombus, atrial fibrillation was present in 2 out of 4 cases, whereas it was found in 44 out of 309 patients (14.2%) without thrombus. The authors suggest that cardiac thrombi are relatively uncommon in TIA and occur less frequently than in AIS, suggesting a lower diagnostic yield of systematic cardiac CT in this population. However, the low detection rate of cardiac thrombi may also reflect potential inclusion of stroke mimics.

In Rehabilitation and Outcome section, I selected the study entitled “Preserved Posterior Circulation Neurovascular Coupling Is Associated with Hemianopsia Recovery at 3 Months After Ischemic Stroke” by Bruno Carvalho et al. from Porto. This study included adult patients with acute ischemic stroke presenting with new-onset homonymous hemianopsia, who underwent posterior neurovascular coupling (NVS) assessment by transcranial doppler (TD) within 72 hours of symptom onset. Preserved NVC as defined as a posterior cerebral artery response in a stimulus within 2 SD of normal values. The primary endpoint was complete recovery of hemianopsia at 3 months. A total of 20 patients were analyzed. Recovery occurred significantly more frequently in patients with preserved NVC (13/15) compared to those with impaired NVC (1/5; p = 0.014). These findings suggest that TCD-NVC may help stratify visual prognosis.

I hope you found these summaries and selection interesting. The quality and diversity of the work presented were highly inspiring!