The Scientific Program - Stroke
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Friday, April 05, 2019 |
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Hall C- DE FALLA |
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07:30-08:30 |
FREE PRESENTATIONS: STROKE |
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08:30-10:10 |
SESSION 13 | STROKE: PREVENTION |
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Chairpersons: |
Balousha Ghassan, Palestine & Exuperio Diez Tejedor, Spain |
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08:30-09:20 |
Is pollution a major contributor to acute stroke on a global scale? Capsule: Air pollution contributes to increased morbidity and mortality from pulmonary and circulatory disorders. The role of particulate exposure to the risk of stroke is not fully defined but may be important. Is there sufficient clinical evidence implicating pollution as a major modifiable risk factor for stroke and can it be reduced with preventative measures? |
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08:30-08:40 |
Host: Adrian Parry-Jones, UK |
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08:40-08:55 |
Pro: Karl Matz, Austria |
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08:55-09:10 |
Con: Vida Demarin, Croatia |
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09:10-09:20 |
Discussions and Rebuttals |
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09:20-10:10 |
Is the polypill a valid concept for prevention of stroke? Capsule: Most patients with stroke require treatment of multiple modifiable vascular risk factors. Does the development of a "polypill" that contains antithrombotic, antihypertensive and cholesterol-reducing drugs improve compliance to treatment and are such pills as effective as the individual drugs? |
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09:20-09:30 |
Host: Adrian Parry-Jones, UK |
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09:30-09:45 |
Yes: Karl Matz, Austria |
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09:45-10:00 |
No: Laszlo Csiba, Hungary |
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10:00-10:10 |
Discussions and Rebuttals |
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10:10-10:25 |
Coffee Break |
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10:25-12:05 |
SESSION 14 | ANTICOAGULATION IN STROKE |
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Chairpersons: |
Vitalii Goldobin, Russia & Aleksandras Vilionskis, Lithuania |
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10:25-11:15 |
Is the demonstration of a high number of cerebral microbleeds (CMBs) a contraindication to anticoagulant treatment? Capsule: Intracerebral hemorrhage (ICH) occurs in patients receiving anticoagulation. This risk may be higher in patients in whom CMBs are identified on MRI. The best management of anticoagulant treatment in patients with high CMB score in not clear. How should patients with high-risk of embolic stroke in whom anticoagulation therapy is indicated but in whom MRI shows CMBs be managed? |
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10:25-10:35 |
Host: Laszlo Csiba, Hungary |
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10:35-10:50 |
Yes: David Werring, UK |
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10:50-11:05 |
No: Mahmut Edip Gurol, USA |
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11:05-11:15 |
Discussions and Rebuttals |
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11:15-12:05 |
What is the best prevention strategy following acute stroke for patients with embolic strokes of undetermined source (ESUS): direct acting oral anticoagulants (DOACs) or anti-platelet medications? Capsule: Two recent large trials with DOACs in patients with ESUS showed no superiority of DOACs over aspirin. Do the results from NAVIGATE-ESUS and RESPECT-ESUS suggest that there is no place for DOACs in ESUS patients? The debate will focus on whether patients with suspected cardiac embolic source should be treated long-term with DOACs to prevent further embolic events, or is treatment with antiplatelet drugs justified? |
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11:15-11:25 |
Host: George Chrysant, USA |
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11:25-11:40 |
DOACs: Georgios Tsivgoulis, Greece |
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11:40-11:55 |
Antiplatelets: Jonathan Streifler, Israel |
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11:55-12:05 |
Discussions and Rebuttals |
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13:05-14:15 |
Lunch Break |
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14:15-15:45 |
SESSION 15 | STROKE THERAPY |
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Chairpersons: |
Maia Beridze, Georgia & Wolf-Dieter Heiss, Germany |
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14:15-14:55 |
Collateral enhancement: Is there sufficient evidence to offer to patients with acute stroke? |
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Capsule: The speed with which irreversible injury develops following an acute stroke is variable. The presence of good pial collateral arteries is perhaps the most important factor associated with slow progression of injury following an acute stroke. But is there sufficient evidence that collateral enhancement can improve stroke outcome and can we apply such therapies in routine patient care? |
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14:15-14:25 |
Host: Natan Bornstein, Israel |
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14:25-14:35 |
Yes: Ashfaq Shuaib, Canada |
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14:35-14:45 |
No: Georgios Tsivgoulis, Greece |
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14:45-14:55 |
Discussions and Rebuttals |
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14:55-15:45 |
Is there sufficient evidence for closure of patent foramen ovale (PFO) in ALL patients after TIAs and acute stroke? Capsule: PFO is a frequent finding on echocardiography done as part of acute stroke investigation. However, not all strokes are necessarily due to its existence. Therefore, although recent studies have provided evidence that PFO closure is superior to medical therapy alone, it is debatable whether closure should be recommended to all patients with demonstrated PFO. |
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14:55-15:05 |
Host: George Chrysant, USA |
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15:05-15:20 |
Yes: Krassen Nedeltchev, Switzerland |
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15:20-15:35 |
No: Jonathan Streifler, Israel |
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15:35-15:45 |
Discussions and Rebuttals |
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15:45-16:00 |
Coffee Break |
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16:00-19:00 |
SESSION 16 | ENDOVASCULAR TREATMENT (EVT) |
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Chairpersons: |
Zdravka Poljakovic, Croatia |
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16:00-16:50 |
Acute stroke patients with suspected large vessel occlusion (LVO): Should they be transferred directly to a comprehensive stroke center (CSC) or for initial assessment at primary stroke center (PSC)? Capsule: EVT for acute ischemic stroke patients with LVO is a safe and effective treatment for selected patients up to 24 hours. For those arriving up to 4.5 hours from onset, IV tPA is still recommended. However, its impact is questionable. This can have a major impact on where we decide to transfer patients, first to the nearest PSC for IV tPA treatment and then to the CSC or directly to CSC. |
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16:00-16:10 |
Host: Antonio Davalos, Spain |
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16:10-16:25 |
Direct: Natalia Perez de la Ossa, Spain |
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16:25-16:40 |
PSC first: Roni Eichel, Israel |
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16:40-16:50 |
Discussions and Rebuttals |
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16:50-17:40 |
Should thrombectomy be performed on extremes (mild stroke or low infarct volume)? Capsule: EVT for acute ischemic stroke patients with LVO in the anterior circulation is safe and has been shown to be most effective when performed on patients with moderate and severe strokes. Little is known about the safety and efficacy of EVT in those patients with mild stroke (<5 NIHSS) or moderate to severe ischemic changes in the admission CT. |
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16:50-17:00 |
Host: Roni Eichel, Israel |
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17:00-17:15 |
Pro: Marc Ribo, Spain |
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17:15-17:30 |
Con: Ashfaq Shuaib, Canada |
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17:30-17:40
17:40-18:30 |
Discussions and Rebuttals
Should secondary stroke prevention include DOACs in addition to aspirin? |
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Capsule: Despite the significant benefits of antiplatelet therapy, stroke victims remain at high risk of stroke recurrence. Long-term vitamin K antagonist therapy was superior to aspirin monotherapy but increased the risk of bleeding. Is combined therapy justified? |
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17:40-17:50 |
Host: Natan Bornstein, Israel |
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17:50-18:05 |
Yes: Laszlo Csiba, Hungary |
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18:05-18:20 |
No: Jonathan Streifler, Israel |
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18:20-18:30 |
Discussions and rebuttals |
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18:30-19:00 |
ICH - new frontiers: Mahmut Edip Gurol, USA |
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END OF FRIDAY HALL C - DE FALLA |
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