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Hubert, G. J., Santo, G., Vanhooren, G., Zvan, B., Campos, S. T., Alasheev, A., … Corea, F. (2018). Recommendations on telestroke in Europe. European Stroke Journal



Lack of stroke specialists determines that many European rural areas remain underserved. Use of telemedicine in stroke care has shown to be safe, increase use of evidence-based therapy and enable coverage of large areas of low population density. The aim of this article is to summarise the following recommendations of the Telestroke Committee of the European Stroke Organisation on the setup of telestroke networks in Europe: Hospitals participating in telestroke networks should be chosen according to criteria that include population density, transportation distance, geographic specifics and in-hospital infrastructure and professional resources. IMG_8869Three hospital categories are identified to be part of a hub-and-spoke network: (1) the Telemedicine Stroke Centre (an European Stroke Organisation stroke centre or equivalent with specific infrastructure and setup for network and telemedicine support), (2) the telemedicine-assisted stroke Unit (equivalent to an European Stroke Organisation stroke unit but without 24 h onsite stroke expertise) and (3) the telemedicine-assisted stroke ready hospital (only covering hyperacute treatment in the emergency department and transferring all patients for further treatment).


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



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.

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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. 

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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.

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stroke guidelines

stroke guidelines



GUIDELINES for Stroke Management

The ESO Guidelines 2008 represent an update of the ESO 2008 and 2003 EUSI Guidelines. Again, they cover the whole spectrum of ischaemic stroke, from teaching and awareness, to stroke unit and stroke management strategies, primary and secondary prevention, acute treatment and rehabilitation.

GermanyBayer has announced preliminary results of the ROCKET AF study, showed how thet the new oral factor Xa inhibitor rivaroxaban (Xarelto (R) ) met its primary efficacy end point of noninferiority to dose-adjusted warfarin on all-cause stroke and non-CNS embolism. The rates of the composite of major and nonmajor clinically relevant bleeding were comparable (the primary safety end point). The overall feeling in the field is not completely satisfactory, but is better to wait the full paper.




Is now visible to the public the Spread portal for Italian Guidelines in Stroke management. The idea is to develop a “real time” tool to update guidelines. The site is not available for normal users just for faculty members.

January 2019
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