European Union Health Commission on Stroke

Brussels, 30th November 2016 – Jon Barrick SAFE President and Valeria Caso President of the European Stroke Organisation of Stroke Professionals had a meeting today at the European Union Health Commission to discuss the quality of Stroke prevention, care and support within the countries of Europe.

SAFE and ESO made a number of proposals aimed at gathering EU support for encouraging countries across Europe to improve stroke intervention. Stroke now accounts for more than 9% of all deaths in Europe and is the leading cause of long term severe disability.

Topics discussed included the Health Commissioners engagement with proceedings at a Stroke Summit meeting to be held in Brussels on May 11th 2017, the dissemination of the Burden of Stroke report with data on the stroke care pathway performance in each European country, and a report on the current situation  around acute stroke care. Also discussed were support for the SAFE, ESO and others initiative to produce a stroke European action plan to be launched in May 2018, and the potential for creation of an economic burden of stroke report by 2019.

The Stroke European action plan will be the sequel to the Helsingborg declaration of 2006, which set objectives to be achieved by 2015. This is now redundant and many new developments and treatments have occurred since its first appearance, and there is now an opportunity to create initiatives to drive down the death and disability rates from stroke.

Other topics covered were the need for greater awareness of stroke, more effort to be made in preventing stroke, and the need to allocate more resources for stroke research generally. SAFE and ESO were encouraged to provide more examples of good practice to be shared country to country, and questions were asked concerning possibilities of good practice pilot activity.

There was found to be a huge overlap between the work of SAFE and ESO, and that of the EU Health Commission, with all parties seeking to make sure stroke care is sustainable, efficient, and supports resilience within health care systems (the capacity to buffer change, learn and develop, enhance adaptive capacity in a situation of rapid treatment transformations).

As such there was agreement that more work to combat stroke makes a positive contribution to the Health programme aims of the EU http://ec.europa.eu/health/programme/policy/index_en.htm.

Airborne Stroke Unit

In the era of mechanical reperfusion, HEMS can be a powerful instrument for improving acute stroke delivery and research that is currently underutilized. The speed of HEMS may allow reperfusion for a large number of patients that would not have immediate access due to geography or traffic congestion. Also, HEMS critical early time period after a stroke where specific interventions to preserve penumbra and prevent reperfusion injury may have a significant influence on outcomes. The impact of physical factors generated by the helicopter on the ischemic brain needs to be studied. HEMS are also an opportunity to increase recruitment of patients in standard clinical trials. Addressing the HEMS stroke gap is necessary to homogenize the delivery of acute stroke care and research capabilities through all care settings, therefore minimizing disparities in outcomes based in geographical location.

European Stroke Journal Sept 2016

The European Stroke Journal

  European Stroke Journal announcement to ESO members

Dear Colleague,
Along with holding our first ESO conference in 2015, one of our major objectives was to create our own journal with the aim that it opens its pages in early 2016. I am delighted to announce that we have moved several steps closer to this target. Following an intensive period of negotiation, on the one hand, and review of a wonderfully strong field of applicants on the other hand, recent days have seen us sign a deal with a publisher and select our most senior editors to lead the formation of the new European Stroke Journal (ESJ).
Our publisher will be the respected UK based firm, SAGE. SAGE publishes a series of medical and scientific journals, is known for its ethical approach and was recently also chosen by our colleagues in the WSO to become the new publisher for International Journal of Stroke, with which we intend to have a friendly and co-operative rivalry.
Our new Editor in Chief will be Bo Norrving, from Lund in Sweden. Bo has impeccable credentials for this role. He is a former President of the World Stroke Organisation and has represented stroke at the World Health Organisation. He has been senior consulting editor for Stroke. He brings vast experience and huge commitment to stroke, to Europe and to the task before him. He will handle the political, ethical, scientific and practical aspects with assurance and diplomacy, and will draw huge credit to ESO and ESJ in the process.
We are equally delighted that Bo will not face this task alone. He will be supported by a vice editor who can claim similar distinction. Didier Leys from Lille in France has expressed his enthusiasm to work alongside Bo in building this exciting new venture for ESO. As well as editorial duties at JNNP for 7 years, Didier also has strong political credentials: he was President of ESO from 2010-2012, and served on the Executive Committee that took the tough decision to establish our independent conference.
We believe that we have a partnership that has the very best people and publisher available and I am sure that you will join in welcoming SAGE and congratulating Bo and Didier in their new roles. We also are confident that all of our fellows and members will do their utmost in practical ways to support the journal. We ask every fellow and member to consider to send just one of their best manuscripts to ESJ over the next year – one that you know is worthy of the top journals in our field – so that we can hit the ground running with a strong flow of first rate papers. Giving one great paper to a new journal will have a negligible effect on your personal publication ranking but will have a major effect on the journal’s chance of a rapid and notable rise into citation territory. It represents a small, inexpensive but tangible way of demonstrating support for ESO and for European stroke science. For the first two years (at least) there will be a prize for the unsolicited paper that attracts the highest number of citations in the 12 months from its first publication in ESJ.
With best regards
Ken Lees
Kennedy Lees

President
Bo Norrving Bo Norrving

Bo Norrving is Professor in Neurology at Lund University, Sweden. He has broad experience in stroke, from clinical research (including many seminar papers and books), publishing (associate/senior consulting editor positions for Stroke and Neuroepidemiology), stroke society leadership (past vice President of the ESO, immediate-past President of the World Stroke Organization), to governmental/ policy positions. The latter include acting as chair of stroke section for ICD 11 at WHO, the WSO Global Policy committee, the Swedish Stroke Register (Riksstroke), and co-chair of the WSO Guidelines and Quality Committee.

Didier Leys Didier Leys 

Didier is Professor of Neurology at the University of Lille, and a former President of the European Stroke Organisation. He has a long history of collaboration in the stroke field within Europe, especially with Finland, Germany, Switzerland and Italy. Didier’s research activity has 3 main orientations: the relationship between stroke and dementia, mechanisms of cervical artery-dissection, and thrombolysis in acute cerebral ischaemia. He has authored 466 publications attracting 15,541 external citations. His served for 7 years as associate Editor of the Journal of Neurology, Neurosurgery and Psychiatry (April 2004-March 2010), and has been editorial board member and reviewer for several other journals.

 
http://www.sagepub.com

Founded 50 years ago by Sara Miller McCune to support the dissemination of usable knowledge and educate a global community, SAGE is a leading international publisher of innovative, high-quality content. SAGE publishes more than 850 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company’s continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore and Washington DC. http://www.sagepub.com

ISO meeting 2016 in Firenze

 

it was held as usual in Florence (CTO) we followed the top trial session. Ongoing RCT were presented mostly from larger international initiatives. Small national activities are also under construction. A large discussion was opened on the chance to address specific educational programs for interventional neurology. The national need of interventional neurologists is large: 100-200 doctors. Should be a radiologist to practice thrombectmy ? a Neurosurgeon (exceeding number in Italy) ? a well trained Neurologists ? The answer from the faculty board is to wait for a new medical figure that will be possibly available in 5-10 years from now.

Thrombectomy in Umbria

The regional Neurology meeting re-opened the issue of local pathways to thrombectomy. The access to most advanced techniques seems slowed by ETS procedures and lack of full week coverage 7/7.

ETT prognostic value in stroke/AF

Anticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). T he identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence. In consecutive patients with acute ischemic stroke and AF, TTE was performed within 7 days from hospital admission. Study outcomes were recurrent ischemic cerebrovascular events (stroke or TIA) and systemic embolism. 854 patients (mean age 76.3 ± 9.5 years) underwent a TTE evaluation; 63 patients (7.4 %) had at least a study outcome event. Left atrial thrombosis was present in 11 patients (1.3 %) among whom 1 had recurrent ischemic event. Left atrial enlargement was present in 548 patients (64.2 %) among whom 51 (9.3 %) had recurrent ischemic events. The recurrence rate in the 197 patients with severe left atrial enlargement was 11.7 %. On multivariate analysis, the presence of atrial enlargement (OR 2.13; 95 % CI 1.06-4.29, p = 0.033) and CHA₂DS₂-VASc score (OR 1.22; 95 % CI 1.04-1.45, p = 0.018, for each point increase) were correlated with ischemic recurrences. In patients with AF-associated acute stroke, left atrial enlargement is an independent marker of recurrent stroke and systemic embolism. The risk of recurrence is accounted for by severe atrial enlargement. TTE-detected left atrial thrombosis is relatively uncommon.

Paciaroni et AL JON 2015

A stroke awareness campaign in Italy

An awarness campaign in Italy by ARS and ALICE. Just developed a leaflet to help recognizing warning signs

Prenatal Stroke initiative

In this touching second chapter, Francesca and Roberto take us through the ideas and actions that followed the first TED talk. How it changed and is still impacting not only their lives but also the people who are experiencing the same challange. Be parents of a child who had a prenatal stroke.

Francesca, Roberto and Mario ( their son) were first on the TED Global stage in 2013. From then on their life changed a lot and a lot of projects took life. On our stage they share their experience and achievements. From Inspiring to activate.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

ESO president letter

As the first European Stroke Organisation Conference has drawn to a close, I want to thank all faculty members and delegates for their intellectual and practical support to the preparation and delivery of what has I believe been an outstanding success. When the overwhelming wish of our association was expressed just 11 months ago that we should establish a new conference, we barely dared to hope for 800-1,000 delegates in our first year. The reality was that 84 countries were represented in Glasgow, and that delegate numbers were close to 2,700. To accompany the presentations to a packed auditorium in our first plenary session alone there were two simultaneous online publications in the New England Journal of Medicine and one in Lancet, and we had new results presented from two additional fresh NEJM publications and an Annals of Neurology paper. In the afternoon, we heard the first multicentre, blinded RCT of an experimental approach in stroke, a stem cell RCT, the complete results of the desmoteplase programme and a further new thrombectomy trial. By the time we retired to the poster session and welcome reception, the exhibition hall was buzzing with excitement. The enthusiasm and cheerfulness were tangible, affecting everyone from the most junior researchers through to old hands. The sun shone on the entire conference, literally. I attribute the success to a huge amount of good fortune, to the efforts of a vast team and to the enthusiasm of every delegate. It would be unfair to single out any one contribution but I am convinced that it was those numerous individual contributions, offered generously and constructively, that allowed us to take advantage of the good fortune. To be present at this inaugural conference was reward enough for anyone working in stroke, because it was a once in a career occasion that we will each remember with great fondness. It was rather like a birth, a christening and a wedding, all rolled into one. Certainly, we have shown what a large and happy family we are in stroke medicine, and that Europe stands not alone but with societies and individuals all across the world. We will build on this success, we will maintain the spirit and principles that informed ESOC 2015, and I promise that by 10-12 May 2016 in Barcelona we will have another outstanding programme. For now, I express my sincere thanks to everyone for their support and hope that each of you left Glasgow with enthusiasm, new friendships and shared optimism for the future, for our patients and our specialty.

KL

Mechanical thrombectomy soon in stroke guidelines

Press release

 

Mechanical thrombectomy improves outcomes in acute ischemic stroke.

 

Joint statement of the European Stroke Organisation (ESO), the European Society  of Minimally Invasive Neurological Therapy (ESMINT) and the European Society of Neuroradiology (ESNR)

 

Stroke results from rupture or interruption of blood flow in brain vessels can lead to devastating consequences for patients, their families and society. Steady progress has been achieved in the last 20 years in stroke treatment through better prevention, establishment of stroke care units and the use of clot-busting drugs (intravenous thrombolysis).

 

Last week, new scientific evidence from four major stroke studies was presented at the International Stroke Conference in Nashville, USA. It proved that rapid mechanical thrombectomy (clot retrieval) improves patient function after acute ischemic stroke. To achieve this benefit, patients were treated by interventional neuroradiologists in stroke centers with multidisciplinary stroke teams. This treatment should be performed as rapidly as possible in conjunction with standard intravenous thrombolysis.

 

ESO, ESMINT and ESNR acknowledge this significant progress in acute stroke treatment and strongly support its application in appropriately selected patients in well equipped stroke centers by properly trained neurointerventionists. Further randomized trials of thrombectomy and more detailed analysis of the current trials will help to optimize patient selection and treatment algorithms.

 

Detailed guidelines on mechanical thrombectomy are currently being prepared by the key European societies involved in acute stroke care. Before these detailed guidelines become available, ESO, ESMINT and ESNR have jointly updated and support the consensus statement on thrombectomy by the ESO-Karolinska Stroke Update (see http://2014.strokeupdate.org/consensus-statement-mechanical-thrombectomy-acute-ischemic-stroke).

Background

 

The European Stroke Organisation (ESO) is a society of stroke physicians, researchers, societies and patient organizations with the goal of optimizing  and harmonizing  the management of stroke in Europe by supporting medical education and stroke projects.

More on www.eso-stroke.org

Contact: esoinfo@eso-stroke.org

The European Society of  Minimally Invasive Neurological Therapy (ESMINT) is a multidisciplinary society of individuals and groups working or training in the field of minimally invasive neurological therapy in geographical Europe. It has been established in order to promote the benefits of minimally invasive neurological therapies through education, training and support for high quality scientific research. 

More on www.esmint.eu

Contact email: office@esmint.eu

 

The European Society of Neuroradiology / ESNR Diagnostic and Interventional is a professional society organising European neuroradiologists. The Society organises Annual Scientific meetings – ESNR Congress, common European Training courses in neuroradiology – European Course of Neuroradiology (ECNR) and is a forum for professional development of European Neuroradiology.

More on www.esnr.org

Contact email : info@esnr.org