Europe – European Stroke Organisation

25th ESO Summer School – a very special week in Birmingham

Michele Schaub Jackson — Fri, 16 Sep 2022 20:09:02 +0000

By Katarzyna Krzywicka

25^th ESO Summer School – a very special week in Birmingham

The 25th ESO Stroke Summer School took place on 5-9 September 2022 in Birmingham, England and was an unforgettable experience – not only because it was a first post-pandemic live (!) Summer School, but also due to very special events taking place in the United Kingdom throughout these five days (announcement of a new Prime Minister, passing of Queen Elisabeth II and appointment of a new King).

In early September, as 50 (aspiring) neurologists from 24 countries gathered in the halls of the University of Birmingham Medical School, the city of Birmingham topped the ranking with a number of stroke enthusiasts per square kilometre. Birmingham, also called “The Heart of England”, temporarily became “The Brain of England” and thanks to fantastic efforts of the organising team – Dr Phil Ferdinand, Professor Christine Roffe, Dr Indira Natarajan, Dr Sissi Ispoglou, Dr Jason Appleton, Dr Don Sims, Dr Girish Muddegowda, all participants of the Summer School enjoyed a delightful mixture of high level stroke education, networking and socialising.

First day was initiated by Professors Gary Ford and Iris Grunwald reminding us about everything we have learned and should know about thrombolysis and mechanical thrombectomy in acute ischaemic stroke. Afterwards, we worked in small groups discussing the importance of venous thromboembolism prevention, oxygen and blood pressure in stroke patients. From Dr Adam Low we learnt about safety considerations of anaesthesia during thrombectomy (always inform the anaesthetist if you expect a complex patient!). Dr Ranjan Sanyal entertained us with an interactive (and very useful!) lecture and provided us with simple algorithm for an often challenging diagnosis in dizzy patients. Dr Sissi Ispoglou triggered a discussion about atypical presentations and underdiagnosis of stroke and Dr Neena Bodasing reminded us of the importance of low-threshold HIV testing and advantages of an opt-out approach. The evening social programme kicked off with a delicious Indian curry dinner (a real Birmingham specialty!).

On a second day, Professors Hanne Christensen and Nikola Sprigg discussed the impact and management of intracerebral haemorrhage. Particularly the difficulty of attaining high quality data and high numbers of patients in intracerebral haemorrhage studies have been highlighted as current problems in the field. An important message was that time is brain – also in intracerebral haemorrhage patients – so do not slow down once you see blood! Consequently, a debate between Dr Adrian Parry-Jones and Dr Jason Appleton on whether elevated blood pressure should be intensively lowered in acute intracerebral haemorrhage patients yielded some unexpected results in voting among the participants – although everyone seemed to agree it should be lowered – the question was – how intensively. Professor David Werring introduced us to cerebral amyloid angiopathy and microbleeds and Mr Edward White took us on a journey from a neurosurgeon’s perspective – arguing that that the guidelines should not be seen as sanctity but that criteria for surgical intervention should be tailored to specific cases. Dr Samer Al-Ali showed us the stroke world from a neuroradiologist’s perspective, and presented a number of interesting cases. Professors Thompson Robinson and Rustam Al-Shahi Salman discussed the role of anti-platelet therapy in both ischemic and haemorrhagic strokes. Professor Joanna Wardlaw introduced us to the small vessel disease – reminding us it is a highly prevalent, important cause of cognitive impairment and very much a dynamic disease. Dr Linxin Li focused on in increased incidence of a young stroke and its possible causes and the scientific part of the day ended with Professor Anita Arsovska giving a comprehensive overview of stroke prevention in women. Evening dinner took place in an Italian restaurant with countless delicious dishes and ended with a luxurious cheese platter.

Third day gave platform to the number of international speakers, also the ESO Executive Committee Members to share their clinical and research interests. Professor Georgios Tsivgoulis gave us an extensive overview of the state of the art of stroke care and frontiers for thrombolysis or thrombectomy (138 slides in 25 minutes challenge?!). Professor Thorsten Steiner gave us perspectives on what future holds for intracerebral haemorrhage. Professor Peter Kelly showed us highly inspiring molecular and imaging approaches to studying inflammation in secondary stroke prevention. Dr Diana Aguiar de Sousa gave us a comprehensive overview of the knowledge about cerebral venous thrombosis (also after COVID-19 vaccination) and future perspectives for this relatively uncommon but highly relevant disease. Professor Martin Dichgans introduced complex but fascinating concepts of genetics in stroke (among others, the use of GWAS) and Dr Else Sandset took us on a personal journey and gave us early career tips (say yes to the opportunities when you are young). Second part of the day was opened by Professors John Camm and Robert Hatala who introduced atrial fibrillation and cardioembolic strokes from a cardiologist’s perspective. Dr Jukka Putaala discussed the young stroke studies with focus on the cardiac causes of stroke. The day was crowned with a royal steak dinner topped off with an elegant sticky toffee pudding (an absolute highlight according to some).

The focus of the fourth day was life after stroke. Important topics were rehabilitation of the motor function of the limbs – introduced by Professor Nick Ward, management of spasticity – discussed by Dr Sachin Vashistha and balancing the exercise post-stroke to achieve better outcomes (importance of strength and aerobic exercises) – by Dr Ulrike Hammerbeck. After the break, from Dr Joseph Kwan we learned about the holistic approach to stroke care and about how little we know about almost miraculous effects of exercise and diet, we discussed fatigue, depression and anxiety in stroke patients with Professor Gillian Mead, and studied late rehabilitation, reintegration and return to work after stroke (physicians unfortunately rarely encourage patients to return to work…) with Professor Avril Drummond. We also learned from Mr Brin Heliwell about how it is to be a stroke patient – he also gave us recommendation about how we should make our work more meaningful for our patients. After lunch, Professor Silke Walter showed us the progress of work on the Mobile Stroke Unit and the challenges associated with introducing them (price and geographic landscape, just to mention two). Professor Christopher Price explained the pre-hospital stroke assessments, including the newest portable diagnostic technology to help identify large vessel occlusion. Lastly, Dr Deb Lowe, Dr David Hargroves and Dr Ajay Bhalla introduced us to a an integrated approach to Stroke Delivery Networks, Stroke National Audit Program and taught us how to bring change in the stroke field. Last evening was celebrated in the Jewellery Quarter of Birmingham, and dancing to an outstanding live band lasted until late night hours.

Fifth day focused on the challenges ahead in the stroke field. Together with Professor Hugh Markus we studied the vertebral artery disease, with Professor Terry Quinn – the often overlooked topic of cognition in stroke and about the unmet need of post-stroke cognitive screening testing. Professor Serefnur Ozturk took on a highly relevant topic – inequalities in stroke care among migrants and refugees. Professor Craig Smith shared the considerations about stroke and COVID-19 infection. Although the risk of stroke is small, once it occurs, it appears to be more severe, more likely with multiple large vessel occlusions. The summer school was concluded by passionate Professor Christine Roffe with a talk on clinical benefits of the hyper-acute stroke unit.

All in all, we certainly learned a lot about the current stroke practices and newest research directions, interacted with brilliant stroke experts from around the world (also learned that many of them have attended an ESO summer school earlier in their careers) and became even more enthusiastic about the field. We met fellow young stroke physicians and spent fantastic five days in Birmingham (which has more canals than Venice!).

It was a highly successful summer school with a well-rounded programme which surely will remembered for many years to come.

Thank you to everyone who made it possible!

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ESO Committee Corner – Trials Network (ESOTA)

Lara Le Noan — Tue, 10 Aug 2021 18:27:16 +0000

10/08/2021/in ESO /by Lara Le Noan

Trials Network Committee

Robin Lemmens, Belgium (Chair)
Christina Kruuse, Denmark
Christine Roffe, United Kingdom
Erik Lundström, Sweden
Jean Marc Olivot, France
Michael Knoflach, Austria
Peter Kelly, Ireland
Philippe Lyrer, Switzerland
Silke Walter, Germany
Simona Sacco, Italy

ESO Trials Alliance (ESOTA)

ESOTA has developed and grown under the inspiring leadership and enthusiasm of Prof Peter Kelly who has recently stepped down as chair. It is become an international European ‘network of networks’ to support stroke randomised trials in Europe and several trials are actively recruiting patients in these networks. The first five research networks included the Dutch CONTRAST Network, Stroke Trials Network Ireland, the UK Clinical Research Network, Swiss Stroke Trials Network and the Spanish Stroke Society Network. Over the years these were joined by the Scottish Stroke Research Network, Turkish Stroke Research and Clinical Trials Network, Stroke Trials Network Germany and Belgian Network for Clinical Stroke Trials resulting in over 400 participating hospitals. ESOTA is in contact with various other national networks which will likely join in this or the coming years.

As ESOC 2021 was converted into a virtual event is was decided to have ESOTA webinar in June 2021. Following the challenging times during the COVID-19 pandemic to recruit patients in stroke trials speakers were invited to talk about challenges and opportunities in the design and development of future studies. Dr. Alistair Nichol underscored the potential of platform trials in critical care medicine which were launch quickly during a pandemic to test multiple hypotheses simultaneously instead of sequentially. A format that could potentially be implemented in stroke trials as well. Dr. Götz Thomalla discussed the challenges and difficulties in obtaining consent in acute stroke trials with the need to waive consent if this cannot be obtained in a reliable manner. Mrs. Kay Duggan Walls provided a comprehensive overview of the Horizon Europe 2021-2027 program including practical advice for investigators with an interest to start an application. In the last presentation Dr. Christine Roffe elaborated on how to successfully engage patients and public in stroke research to benefit both patients and researchers.

To improve the visibility of ESOTA the website (https://eso-trialsalliance.org) has received an update. It now includes an oversight of the aims and goal of ESOTA, participating centers and their interest, stroke trials within Europe and other supportive material. In the coming months the possibility of an implementation of a comprehensive trials dictionary will be discussed. The idea is to compile information for national regulations.

The main goal of ESOTA remains to make it easier for ESO investigators to conduct multinational stroke trials in Europe. ESOTA investigators seeking collaborators for their trials can find contact details for each network on the website including the interests of each participating center. Stroke researchers in countries that have not yet joined ESOTA can find the membership information on the website. Investigators can always send an email to esoinfo@eso-stroke.org for further information on ESOTA.

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Stroke prevention in patients with diabetes: what is known and what are new perspectives?

Lara Le Noan — Fri, 22 Jan 2021 07:22:44 +0000

22/01/2021/in ESO, Stroke Research /by Lara Le Noan

By Inna Lutsenko, MD,neurologist and specialist, Center for Distance Learning and Advanced Training, Kyrgyz State Medical Academy after I.K.Akhunbaev; twitter: @inna_lutsenko

In 2013, 382 million people had diabetes, and this number is expected to rise to 592 million by 2035 [3]. It’s well known that diabetes mellitus is an independent risk factor for ischemic stroke [1-8]. Diabetes also increases the risk of stroke-related dementia by more than threefold [4]. Hence, an urgent global healthcare priority is preventing heart attacks and strokes in diabetic patients.

Pathogenically, the diabetic milieu is characterised by a chronic state of low-grade inflammation, endothelial dysfunction, hypercoagulability, dyslipidemia and insulin resistance [5]. So, the hyperglycaemia specifically affects vascular structure and function by four mechanisms: it increases the oxidative stress and free radical-mediated damage, induces the formation of advanced glycosylation end products, promotes diversion of glucose into the aldose reductase pathway and activates isozymes of protein kinase C.

Hyperglycaemia in the acute phase of stroke has been established as a predictor of poor outcome in all patients, but particularly more so in those not previously known to have diabetes – stress hyperglycemia [7]. Chronic hyperglycemia leads to intima media changes of the thinnest vessels of the Willis circle, e.g.thalamic and lenticulostriate arteries, which can result in cerebral small vessel disease, including white matter changes, cerebral microbleeds, and acute ischemic stroke, with the latter being mostly the lacunar subtype. Ischaemic strokes can also be of the posterior circulation of the brain. In some patients, chronic hyperglycemia is not diagnosed prior to the stroke event and regrettably stroke may be the first manifestation.

Fortunately, with many developments in primary prevention, we now have several ways to prevent stroke in patients with diabetes. Recent ESC guidelines [4], updated in 2019, recommend that patients with diabetes mellitus at high risk of cerebrovascular events maintain systolic arterial pressure during treatment to at 130 mmHg and <130 mmHg if tolerated but not <120mmHg. Antiplatelet agents (aspirin) at a dose of 75–100 mg / day for primary prevention may be considered in very high / high risk patients with diabetes mellitus in the absence of clear contraindications. Metformin is indicated for overweight patients with T2DM with moderate cardiovascular risk of CVD, and for patients with diabetes and atrial fibrillation, NOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) are recommended. SGLT2 inhibitors are recommended for patients with T2DM with very high / high cardiovascular risk to reduce cardiovascular events, and the GLP-1 receptor agonist is recommended for patients with T2DM and CVD or very high / high risk of CVD in order to reduce the risk of fatal CVD complications. A meta-analysis including 18 686 patients with DM demonstrated that a statin-induced reduction of LDL-C by 1.0 mmol/L (40 mg/dL) was associated with a 9% reduction in all-cause mortality and a 21% reduction in the incidence of major CV events, so regular therapy with statins is highly recommended as well.

In addition to medication, it has been suggested that patients with both insulin resistance and diabetes mellitus should engage in regular aerobic exercise, which not only decreases the secretion of pro-inflammatory cytokines, such as TNF-alpha and IL-1-beta, but also increases antioxidant levels, which in turn improve insulin sensitivity. In other words, in addition to drug therapy, lifestyle management also plays a key role in the prevention stroke in patients with diabetes mellitus

References:

Adrià Arboix, Antoni Rivas, Luis García-Eroles, Lourdes de Marcos, Joan Massons and Montserrat Oliveres. Cerebral infarction in diabetes: Clinical pattern, stroke subtypes, and predictors of in-hospital mortality. BMC Neurology 2005, 5:9 doi:10.1186/1471-2377-5-9. http://www.biomedcentral.com/1471-2377/5/9
Chih-Cheng Hsu, Pai-Feng Hsu, Shih-Hsien Sung, Shih-Te Tu, Ben-Hui Y, Chi-Jung Huang, Hao-Min Cheng. Is There a Preferred Stroke Prevention Strategy for Diabetic Patients with Non-Valvular Atrial Fibrillation? Comparing Warfarin, Dabigatran and Rivaroxaban. Anticoagulation for Diabetic Atrial Fibrillation. DOI https://doi.org/10.1160/TH17-02-0095. ISSN 0340-6245.
Guariguata L,Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014;103(02): 137–149
Francesco Cosentino et al. 2019 ESC Guidelines on diabetes, prediabetes, and cardiovascular diseases developed in collaboration with the EASD. The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). European Heart Journal (2019) 00, 169 ESC GUIDELINES doi:10.1093/eurheartj/ehz486
Luchsinger JA, Tang MX, Stern Y et al. Diabetes mellitus and risk of Alzheimer’s disease and dementia with stroke in multiethnic cohort. Am J Epidemiol 2001; 154: 635–41.
Idris I, Gray S, Donnelly R. Protein kinase C activation: isozyme-specific effects on metabolism and cardiovascular complications in diabetes. Diabetologia 2001; 44: 659–73.
Capes SE, Hunt D, Malmberg K et al. Stress hyperglycemia and prognosis of stroke on nondiabetic and diabetic patients. A systematic overview. Stroke 2001; 32: 2426–32.

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Comment: Value of Treatment by Comprehensive Stroke Services for the reduction of critical gaps in acute stroke care in Europe.

Lara Le Noan — Fri, 08 Jan 2021 07:59:35 +0000

Comment by Dr Nicolas Martinez-Majander, Department of Neurology, Helsinki University Hospital, Finland

According to the World Health Organization, noncommunicable diseases (NCD), such as cardiovascular diseases, cancer, and chronic obstructive pulmonary disease account for 80% of deaths in the European Region. Particularly, diseases of the circulatory system (e.g. stroke) are the most important cause of premature death in Europe, accounting for nearly 50% of the total. Stroke is also the leading cause of disability and a major cause of dementia in Europe.^1,2

In 2018, European Stroke Organisation (ESO) prepared a European Stroke Action Plan for the next decade, in cooperation with the Stroke Alliance for Europe.³ As described in this plan, four ambitious targets for the next decade were identified: (1) to reduce the absolute number of strokes in Europe by 10%, (2) to treat 90% or more of all patients with stroke in Europe in a dedicated stroke unit as the first level of care, (3) to have national plans for stroke encompassing the entire chain of care, (4) to fully implement national strategies for multisector public health interventions.

In this paper, published in the European Journal of Neurology, Vanhooren and colleagues present their study and results. A Markov model was used to determine cost-effectiveness of comprehensive stroke services. Outcomes included total costs, QALYs, incremental costs, incremental QALYs, as well as the incremental cost-effectiveness ratio (ICER). Several interventions, such as IVT with alteplase, early aspirin use, and rhythm monitoring for atrial fibrillation, were explored. The model was adapted to the UK setting due to availability of data.

The main findings were as follows:

Key unmet needs in stroke patient pathway and significant gaps in implementation of effective interventions included low implementation of comprehensive stroke services, inadequate treatment of atrial fibrillation, and limited access to rehabilitation.
Full implementation of comprehensive stroke services could led to an absolute risk reduction in death or dependency of 9.8% and the average cost of this intervention was £9,566 vs £6,640 in the standard of care group. Furthermore, long-term care costs were £35,169 per 5.1251 QALYs vs £32,347.40 per 4.5853 QALYs, yielding an ICER of £5,227.89.
With a literature search, the authors showed that these results were also comparable to previous estimates of the cost-effectiveness of establishing comprehensive stroke services.

In conclusion, the authors recommend most importantly that primary and secondary prevention of stroke should be improved (especially identification and treatment of individuals with asymptomatic atrial fibrillation), implementation of comprehensive stroke services should be fostered, and access to timely and effective rehabilitation should be improved. Filling these gaps was shown to be cost-effective and could reduce the prolonged impairment, dependency and loss of productivity caused by stroke. Other recommendations for development of comprehensive stroke services referring to the Stroke Action Plan 2018-2030 (ESO) can be found in the paper itself below.

Webb, A.J.S., Fonseca, A.C., Berge, E., Randall, G., Fazekas, F., Norrving, B., Nivelle, E., Thijs, V., Vanhooren, G. and (2020), Value of treatment by comprehensive stroke services for the reduction of critical gaps in acute stroke care in Europe. Eur J Neurol. https://doi.org/10.1111/ene.14583

References

Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: Findings from the global burden of disease study 2010. Lancet. 2014;383:245-254
Pendlebury ST, Rothwell PM. Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: A systematic review and meta-analysis. Lancet Neurol. 2009;8:1006-1018.
Norrving B, Barrick J, Davalos A, et al. Action Plan for Stroke in Europe 2018-2030. Eur Stroke J. 2018;3:309-336.

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Call for Venue for ESOC 2024

Lara Le Noan — Mon, 28 Sep 2020 09:13:45 +0000

28/09/2020/in ESOC /by Lara Le Noan

Call for Venue

ESO is excited to announce the Call for Venue nominations for the 2024 European Stroke Organisation Conference (ESOC). Choosing a venue for a future conference has political, financial and logistical implications and hence requires careful consideration. ESO has put efforts in defining a process that follows democratic principles and secures transparency. ESO cordially invites venue nominations from ESO members in good standing for consideration by the Board of Directors and the Executive Committee.

The selection of ESO Conference venues is based on rotation around Europe. Given the rapid growth of the conference, ESO will make every effort to rotate evenly but logistic and strategic aspects will need to be taken into consideration.

Nomination and Evaluation

The nomination should come from a national or regional neurological or stroke society, and not from a conference venue. Below you will find an overview of requirements for ESOC 2024, and for the nomination itself.

We look forward to receiving your nominations by 20 November 2020.

Please ensure that your nomination is in line with the below listed requirements. The application for holding an ESO Conference is a two-stage process. A final and detailed bid is requested only after your venue has been shortlisted.

The Executive Committee will discuss all nominations and can propose an additional three cities, which will subsequently be discussed with the Professional Conference Organiser (PCO) in light of available dates, competing conferences, etc. Finally, a shortlist will be determined, partly based on additional information collected by the PCO.

ESOC 2024 – Venue Requirements

City: City in a secure and politically stable European country. The city should be well accessible (especially by train or plane) and have a good public transportation system.
Meeting month: May
Length of meeting: 3 days (plus 2 days pre-conference setup and possibly 1 day post conference for dismantling), usually Wednesday to Friday
Size: approximately 5,000+ persons

Past ESO Conferences Overview

2015: Glasgow (Northern)

2016: Barcelona (Southern)

2017: Prague (Eastern/central)

2018: Gothenburg (Northern)

2019: Milano (Southern)

2020: Vienna (Eastern/Central) – VIRTUAL

2021: Helsinki (Northern)

2022: Lyon (Southern)

2023: to be communicated

2024: ??

Nominations should include the following:

Why should your national or regional society host ESOC 2024? Please present a summary (max. 250 words)

Why should the city be chosen? Please present a summary (max. 1 page)

Support of the city Does the city provide any grants or other benefits to the society?

Information about congress centre:
- Plenary Hall with a minimum capacity of 2’500 seats
- Overview of the available break-out rooms and exhibition space
- Overview of additional meeting rooms & areas (poster space, registration, catering, speaker room, office space, etc).
- Floor plans
- Facilities/services available, catering options
- AV
- Location within the city

2 possible dates in the required month

Infrastructure
- Possibilities for travel to the host city by train.
- Transportation within the city (access to the congress centre from the airport and the city centre)

Accommodation
- Hotel capacity within the city (including breakdown of categories)
- Hotel price range (e.g. 4*: € 120.00-200.00)

General Information
Contact person(s)

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ESO and SAFE kick-off the implementation of the Stroke Action Plan for Europe (SAP-E) –a major initiative to reduce the burden of stroke in Europe

Lara Le Noan — Mon, 14 Sep 2020 10:36:36 +0000

14/09/2020/in ESO /by Lara Le Noan

10.09.2020 Basel – European Stroke Organisation (ESO) and Stroke Alliance for Europe (SAFE) initiated the implementation phase of the Stroke Action Plan for Europe 2018-2030, with a virtual meeting of over 80 experts from 52 countries, each involved within their national scientific societies or stroke support organisations.

The Stroke Action Plan sets targets for 2030 that include a major reduction in new strokes, stroke unit care as first level of care, and national plans for stroke services. At present, less than half of all patients with stroke in Europe receive appropriate care, with large inequalities between and within countries. By adopting evidence based principles of prevention and care, the burden of stroke in Europe can be substantially reduced with large cost savings for the society.

In his introduction, ESO President Prof. Martin Dichgans, Munich reinforced the initiative’s overall goal of creating a framework that will assist countries to improve stroke care across Europe. It is “only with the involvement, collaboration and joint effort of you, the representatives of national scientific societies and patient organisations, that this aim can be achieved”, he said.

The SAP-E Steering Committee presented detailed insights regarding the preparation work and achievements to date as well as an outlook for the upcoming years.

Arlene Wilkie, SAFE Director General, identified the major unmet needs from the perspective of patients and carers in the different regions of Europe. Prof. Hanne Christensen, Copenhagen outlined how the Stroke Action Plan shall be implemented on a national level: “By signing a SAP-E declaration, Ministries of Health, Stroke Support Organisations and Stroke Scientific Societies commit to support and act proactively within the plan in their countries to reach the targets of SAP-E”.

Components of the plan include prevention, care, surveillance, and monitoring of key performance indicators across Europe. As a pan-European initiative, SAP-E will convene authorities, health care providers and patients together to reduce the burden of stroke by a collaborative and systematic effort. The SAP-E is the largest stroke project ever undertaken in Europe.

The official Stroke Action Plan for Europe publication and further detailed information can be found on the Action Plan Website. https://actionplan.eso-stroke.org/

Contact:

ESO Head Office

esoinfo@eso-stroke.org

About ESO

The European Stroke Organisation (ESO) is a pan-European society of stroke researchers and physicians, national and regional stroke societies and lay organisations founded in the 2007. The aim of the ESO is to reduce the burden of stroke by changing the way that stroke is viewed and treated. This can only be achieved by professional and public education, and by making institutional changes.

ESO serves as the voice of stroke in Europe, taking action to reduce the burden of stroke regionally and globally. www.eso-stroke.org

About SAFE

The Stroke Alliance for Europe (SAFE) is an international non-profit-making organisation formed in 2004 in Brussels, Belgium. It is the voice of stroke for patients in Europe, representing a range of stroke support organisations from more than 30 European countries. SAFE’s goal is to decrease the number

of strokes in Europe by advocating for better prevention, access to adequate treatment, post-stroke care and rehabilitation. For more information about SAFE, please visit www.safestroke.eu

The post ESO and SAFE kick-off the implementation of the Stroke Action Plan for Europe (SAP-E) –a major initiative to reduce the burden of stroke in Europe first appeared on European Stroke Organisation.

Stroke Winter School Bern, January 2020

ESO-admin — Fri, 07 Feb 2020 07:27:00 +0000

07/02/2020/in ESO, Stroke Research /by ESO-admin

By Alex Alban Christensen, Odense, Denmark

Flying into Switzerland, this amazing country of multilinguism, direct democracy, technology, fantastic nature and its very own take on European culture, our high expectations were initially hampered by a greeting of pouring rain.

Luckily those of us that had done their homework had brought umbrellas.

We found our way to the Inselspital and the SITEM, a newly constructed glassy framed building, being home to a 7 Tesla MRI for research purposes as well as to the Stroke Winter School for the upcoming 4 days, while offering spectacular views of the Jungfrau, Eiger and Mönch mountain range.

The last accreditations were retrieved with anticipation, and then, the alphorns sounded to kick off the lectures. Precision and punctuality are known as Swiss attributes, and it was noted that even the Italians were on time!

The course aimed to bring young neurologists and neurointerventionalists together and take new knowledge and inspiration home to their respective stroke settings and networks, and we thus arrived as teams of two, consisting of one neurologist and one neurointerventionalist.

To facilitate participation from all around Europe and beyond, the course fee including hotel costs, delightful 3 course dinners every night, local transport – and of course the first cocktail in the Abflugbar – was kept very low, or as ESO President elect Dr. Bart van der Worp explained, the cost of two newly released Swiss 1/4 Franc gold coins in the Albert Einstein version.

The Swiss surely know a thing or two about economics!

The lectures, provided by local and international experts, had a general focus on acute stroke treatment, but there were also important slots for topics like preventional medicine, palliation in stroke or the organization of a stroke network. Imagine the best of lectures in the bigger conferences in an intimate setting, and you have the Stroke winter school 2020.

There were workshops with practical simulations for the interventionalists that were very well received, and the neurologists went through an emergency room stroke simulation as well as workshops with interventionalists, were treatment choices and perspectives could be discussed.

The tone throughout was jovial and informal, and discussion and questions were strongly encouraged. There could be no doubt of the sincere goal of the organizers and faculty members to make this the very best experience possible for the participants, with the larger perspective of improving future stroke care in the respective local setting.

A main focus of a joint ESO-ESMINT course was to strengthen the relationship between the teaming neurologist and neurointerventionalist. It may sound trivial, but there is a real value in getting better understanding for the issues that our close colleagues in stroke treatment are facing. Even before this course, I have personally seen this need, and felt that we should talk plenty more!

We should not work in our own disciplines for ourselves, but together as a team, which will both make it more fun and lead to better results for our patients.

Personally, I now feel better prepared to discuss the pros and cons of thrombectomy via the ACOM or of the antegrade versus retrograde approach in a tandem lesion, and look forward to more dialogue. Finding this time in a busy day can be a problem, but is something that I will aim for.

Each night, we went out to dinner in amazing locations around Bern.

One highlight was taking the Gurtenbahn up to the 855 m hilltop of Gurten, overlooking Bern. Finally, we were treated to some snow, and those of use living in a snow deprived temperate climate rejoiced.

The view was fantastic as was the food, and in general the social events in the evenings gave us all, course participants and faculty members, a chance of getting to know each other and to exchange professional experiences, as well as needed conversations far away from work related topics.

On the day before departure, after dinner we were invited to the Abflugbar, or Departure bar, in central Bern, and we all had a great time socializing deep into the night. Rumors say that Bern`s nightlife was tested further afterwards.

To quote the farewell greetings of a young German colleague from the newly created Stroke Winter School 2020 WhatsApp group, it was an “inspiring week meeting so many unique, dedicated and smart doctors from all over Europe and beyond”.

I fully subscribe to this, and I am confident that all of you will go home and be a part of taking stroke medicine to the next level in your countries.

For young neurologists and neurointerventionalists reading this blog, participation in the ESO Stroke Winter School can only be encouraged. You will be happy to have been part of the experience.

On the last day, the sun was finally shining, as if the city wanted to bid us farewell in its full glory.

What a beautiful and unique city it is, and going back to our Danish island of Fyn, we will miss it.

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Stroke Action Plan Europe: first steps towards implementation

ESO-admin — Tue, 24 Sep 2019 10:09:49 +0000

Committee Members

In Photo L-R: Luzia Balmer, Urs Fischer, Diana Aguiar de Sousa, Jelena Misita, Valeria Caso – Advisor, Martin Dichgans, Bo Norrving – Advisor, Hanne Christensen, Cristina Tiu, Robert Mikulik, Markus Wagner, Francesca Romana Pezzella, Grethe Lunde, Bart van der Worp (not pictured)

One year after the publication of the Stroke Action Plan for Europe the Steering Committee Implementation, consisting of ESO and SAFE members, met for the first time at the end of August to discuss KPIs for each of the seven domains of the Action Plan, strategy framework and dissemination.

The central role of both national professional stroke societies and stroke support and patients organization in the realization of the project was evident as well as the importance of registers to drive actions at multiple level in order to achieve the stroke action plan goals and targets by 2030.

There are wide inequalities in access to care and in the offer of the type of treatment for stroke patients in Europe, the Action Plan aims not only to improve the treatment and containment strategies of the disease but also to make it more easily accessible through evidence based policies throughout the whole European Region.

This necessitates a careful mapping of national, regional and local realities against the action plan seven domain KPIs and close collaboration with all national stake holders, such as governmental bodies, active national stroke societies, European agencies, and all current initiatives in the field of improving stroke care such as the recently established IRENE- Implementation Research Network in Stroke Care Quality; the valuable work carried out by the individual ESO committees will also contribute to the implementation of this project.

Contacts with interlocutors such as EAN, WSO, WHO, national societies, with which to build synergies have already been started or will soon be.

In terms of dissemination the need to effectively communicate outside the activities that take place for the implementation of the action plan is crucial to its success, the scientific community and the public in general will be informed by various means, social networks, press releases, and certainly, from now on, it will be our care to inform constantly also through the ESO newsletter.

It is our intention to make the realization of this project as participatory as possible, this is certainly a key element of success and to be able to reach the goals set for ten years from now.

The post Stroke Action Plan Europe: first steps towards implementation first appeared on European Stroke Organisation.

European Stroke Action Plan Implementation: First Steering Committee meeting held in Munich

ESO-admin — Fri, 30 Aug 2019 06:50:37 +0000

Munich, 29 August 2019

The first Steering Committee meeting for implementation of the European Stroke Action Plan (ESAP) took place in Munich. The Steering Committee’s main tasks include defining a strategic framework, identifying the key performance indicators (KPI) for monitoring the quality of care and reaching targets, as well as providing a definition of a dissemination strategy.

” We have a golden moment now for this plan: we can prevent and treat stroke, and globally stroke plans are shifting the tide. On the other hand, if we do not all work together- health professionals, stroke support organisations, health care providers and governments – the pure number of predicted strokes will overload the health care systems of Europe.” says Hanne Christensen, Chair of the Implementation Steering Committee.

The ESAP implementation will cover all aspects of stroke as defined by the domains:

Primary prevention,
Organisation of stroke services,
Management of Acute stroke,
Secondary Prevention,
Rehabilitation,
Evaluation of outcomes and quality,
and Life after stroke.

Moreover, the implementation will follow the conclusions of the published document. The ESAP Steering Committee will define KPIs and finalize these in close collaboration with the stakeholders including but not limited to national scientific societies and governmental representatives and establish a monitoring platform to ensure accountability in reaching the targets. The Steering Committee will further define a collaborative dissemination strategy together with various stakeholders.

To increase the impact of this initiative, the Steering Committee will collaborate with other existing initiatives in improvement of quality in stroke care in Europe. Within that frame, a collaboration with IRENE-COST, World Stroke Organisation (WSO), WHO Europe or other stakeholders has been a topic of discussion at the meeting in Munich.

About the Stroke Action Plan
The European Stroke Action Plan 2018-2030 is a document created as a result of ongoing collaborative work between SAFE and ESO.

Building on the preceding Helsingborg Declarations of 1995 and 2006, the European Stroke Action Plan creates an aspirational framework to drive healthcare policy, research priorities, local stroke management and patient-focused care. The ESAP is guided by the necessity to meet the requirement demonstrated in the ESO/SAFE Burden of Stroke report, with €45 billion direct and indirect healthcare costs each year, a 34% increase in strokes by the year 2035 due to the ageing population, and huge variations in the level of stroke care available across Europe.

The popular version of the Stroke Action Plan for Europe 2018-2030 can now be downloaded from HERE.
The complete scientific version, he European Stroke Action Plan is available starting from today and can be downloaded from the following LINK.

About the Steering Committee for implementation of the Stroke Action Plan
The Steering Committee consists of one chair, two co-chairs (one from SAFE, one from European Stroke Organization (ESO)), eight Steering Committee members (six from ESO, two from SAFE) and two advisors (ESO).

Members of the Implementation Steering Committee:

Chair: Hanne Christensen
Co-Chair (SAFE): Arlene Wilkie
Co-Chair (ESO): Francesca Romana Pezzella
Members (SAFE): Grethe Lunde, Jelena Misita
Members (ESO):, Bart van der Worp, Martin Dichgans, Diana Aguiar de Sousa, Robert Mikulik, Cristina Tiu, Urs Fischer
Advisors: Bo Norrving, Valeria Caso
ESO Support: Luzia Balmer

The post European Stroke Action Plan Implementation: First Steering Committee meeting held in Munich first appeared on European Stroke Organisation.