European Stroke Organizational Report
During the past 3 years, the European Stroke Organisation (ESO) has seen the launch of its annual congress, its growing attendance, and a boom in the society’s membership with currently >7000 professionals enrolled as members. Within this 3-year period, 36 National Stroke societies throughout the world have joined as associate members with the expressed intent to adhere to and promote stroke diagnosis and treatment according to ESO stroke treatment standards.
At the 2017 ESO Conference (ESOC) held in Prague, and chaired by Martin Dichgans, the number of submitted abstracts was >1800, and the number of participants exceeded 4000 clinicians, researchers, and other healthcare professionals. Many investigators chose ESOC 2017 to present landmark results of their studies, including >12 randomized controlled trials. Tudor Jovin and Raul G. Nogueira presented the final results from the DAWN trial (Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo) reporting superior functional outcomes at 90 days with endovascular thrombectomy plus medical management compared with medical management alone in carefully selected patients with ischemic stroke and a proximal intracranial artery occlusion, treated 6 to 24 hours after last seen. Two trials on patent foramen ovale closure were presented: CLOSE (Patent Foramen Ovale Closure or Anticoagulants Versus Antiplatelet Therapy to Prevent Stroke Recurrence) and Gore-REDUCE (GORE® HELEX® Septal Occluder / GORE® Septal Occluder for Patent Foramen Ovale [PFO] Closure in Stroke Patients). Further trials focused on tenecteplase for intravenous thrombolysis (NOR-TEST [Norwegian Tenecteplase Stroke Trial]), on aspiration in patients with large-vessel occlusion (ASTER [Interest of Direct Aspiration First Pass Technique (ADAPT) for Thrombectomy Revascularization of Large Vessel Occlusion in Acute Ischaemic Stroke]), and on general anesthesia versus conscious sedation during endovascular therapy for ischemic stroke (ANSTROKE [Sedation Versus General Anesthesia for Endovascular Therapy in Acute Stroke-Impact on Neurological Outcome] and GOLIATH studies [General or Local Anaestesia in Intra Arterial Therapy]).
At ESOC 2017, Joanna Wardlow, Professor of Applied Neuroimaging and Honorary Consultant Neuroradiologist at the University of Edinburgh, was awarded with the ESO Presidential Award for her worldwide leadership role in effectively defining diagnostic criteria in stroke treatment and prevention. Joanna Wardlaw has published >550 papers, many of which in high-impact journals, which have attracted in excess of 13 000 citations. The ESO Scientific Excellence Award 2017 was given to Prof Daniel Strbian who has led research that culminated in the DRAGON (predicts functional outcome in the hyperacute phase of intravenous thrombolysis) and SEDAN (predicts risk of symptomatic intracerebral hemorrhage after tPA) scores. At the conference, the space allocated to allied health careers was enlarged in recognition of their contribution to stroke care and research.
ESOC 2018 will be held in Gothenburg, Sweden, from May 16–18, 2018.
ESO has decided to draft a European Action Plan for Stroke in Europe during the period 2018 to 2030, in collaboration with the patient organization Stroke Alliance for Europe (SAFE). Two earlier consensus conferences on stroke management in Europe were held in 1994 and 2006. These conferences were organized by the European Stroke Council (1994) and the International Stroke Society (2006) in cooperation with the World Health Organization. The consensus documents (The Helsingborg Declarations) were used as a basis for setting up and planning stroke services. Previous declarations reviewed current evidence, set up fixed targets, and identified prioritized areas of research. A third European consensus conference is scheduled to take place in 2018.
There will be 6 domains of this Action Plan, 5 from the Helsingborg Declarations, plus Primary Prevention.
- Primary Prevention
- Organization of Stroke Services
- Management for Acute Stroke
- Secondary Prevention and Organized Follow-Up
- Evaluation of Stroke Outcome and Quality Assessment
For each domain, prioritized research areas will be identified. Besides the prioritized research areas of the 6 domains above, there will also be a separate group who will be in charge of identifying prioritized research areas for translational stroke research.
All costs related to drafting the document, as well as its final face–face meeting, will be covered by the ESO. This meeting will be streamed live and open to participation and discussion through ESO social media. The Action Plan will be presented at ESOC 2018 and submitted for publication thereafter. The Action Plan will be coordinated by Bo Norrving, former World Stroke Organization president, and Valeria Caso as current ESO president.
ESO has developed a much called for standard operation procedure dealing with the endorsement of stroke research in the fields of diagnosis, prevention, and treatment. This policy document will be posted on the ESO website shortly.
ESO, the European Society of Minimally Invasive Neurological Therapy, the European Academy of Neurology, and the SAFE have concluded the first part of their joint survey on current endovascular stroke treatment and management standards throughout Europe. This first phase has been successfully accomplished by the ESO General Secretary Urs Fischer and Diana de Aguiar Dias de Sousa. Data have been collected by nominated national representatives, and the results from part 1 of the questionnaire were presented at ESOC 2017.
SAFE and ESO have signed a memorandum of understanding where they commit to supporting joint initiatives that encourage stroke research and public activities.
To date, this collaboration has led to a meeting at the Safety Commission Cabinet in November 2016, whereas in May 2017, SAFE and ESO spearheaded a European stroke summit entitled “Understanding the Burden of Stroke in Europe” at the European Parliament in Brussels, where the Burden of Stroke Report and the ESO European Society of Minimally Invasive Neurological Therapy European Academy of Neurology SAFE Survey results were presented.
Finally, the ESO-EAST project (Enhancing and Accelerating Stroke Treatment) that was launched in 2014 with the mission of Enhancing and Accelerating Stroke Treatment in Eastern Europe is the first comprehensive international program focusing on promoting adherence to current ESO stroke care standards. More info is available on http://eso-stroke.org/eso-east/. The ESO-EAST project has been successfully led by Robert Mikulik from St. Anne’s University Hospital Brno, Czech Republic, and coordinated by Veronika Svobodova. At the third ESO-EAST Workshop at ESOC 2017, stroke data from the Registry of Stroke Care Quality including >220 hospitals from 25 countries were presented (www.qualityregistry.eu).
By September 2017, all ESO activities will be structured according to a 3-year business plan. Specifically, this plan recognizes 5 distinct pillars of ESO priorities: quality improvement programs, education, research support, advocacy, membership, and leadership support service. Thereafter, a position paper declaring the mission of ESO will be published.
All these membership activities give credence to ESO’s aim of being the European point of reference and support for stroke professionals around the world. Details of other ESO activities and opportunities can be found at http://www.eso-stroke.org.
- © 2017 American Heart Association, Inc.