Friday, May 4

Insights from completed/ongoing EVT acute stroke RCTs

15 minute talks and 5 minutes of discussion

Moderators: M Goyal, M Hill

1300-1310 Welcome/IntroductionM Goyal
1310-1330 HERMES highlights M Goyal
1330-1350 Tissue and Time: EVT trials DAWN/ DEFUSE-3 trials B Menon
1350-1410 Tissue and Time: Intravenous thrombolysis trials A Demchuk
1410-1430 MR CLEAN new trialsA van der Lugt
1430-1500 Coffee Break

Future clinical trials

This next session is on future clinical trials. A case vignette would be presented on a specific theme that is potentially material for a clinical trial. The audience will then be polled on management. Each speaker would then present his/her case for a trial. The topic would then be open to polling again for management. Before and after polling results would be presented and the forum opened to general discussion.
1500-1505 Case presentation #1
1505-1530 Extending boundaries for EVT (low ASPECTS)J Fiehler
1530-1535 Case presentation #2
1535-1600 Extending boundaries for EVT (low NIHSSA Demchuk
1600-1605 Case presentation #3
1605-1630 Extending boundaries for EVT (distal occlusion trials) B Menon
 
1630-1645 Making sense of it all: Individualized treatment decision in acute stroke
U Fischer
1645-1700 Areas for future RCTs/Q &A
1800-1930 Cocktails and social hour
1930-2130 Dinner
2130-0000 Socializing

Saturday, May 5

Strokes of A Clock

Challenges, solutions and innovations from first contact to endovascular therapy and beyond

These workflow and process oriented sessions will focus on each interval step leading up to EVT administration and subsequent medical care. At the beginning of each session, an exemplar case vignette will be presented that highlights a decision-making problem. Invited speakers will then present their views on the problem and offer solutions. Technology/innovations in our field for each interval step will be highlighted where applicable. The session will then be thrown open to the audience using an interactive framework that will involve qualitative interactions.
0800-0845 Session 1: Decision-making in the field
Moderators: A Alexandrov, M Jayaraman
0800-0810 Mobile stroke units A Alexandrov
0810-0820 Optimal triaging algorithmsJ Holodinsky
0820-0830 DestineN Kamal
0830-0840 Technology: NeuroAnalytics R Hamilton
0840-0845 Q and A
 
0845-0915 Session 2: Patient arrived at the primary stroke centre first
0845-0855 Imaging at the PSC M Almekhlafi
0855-0905 Fast DIDO: How to do it? R McTaggart
0905-0910Technology: CLOTBUSTER to TRUST TrialsA Alexandrov
0910-0915 Q and A
 
0915-0945 Session 3: Imaging at the CSC
0915-0925 Onset to imaging < 6 hours A van der Lugt
0925-0935 Onset to Imaging > 6 hours D Dowlatshahi
0935-0945 Q and A: How should you manage late patients if you don’t have CTP or CTP uninterpretable due to patient motion?
 
0945-1015 Session 4: Medical treatments before EVT
0945-0955 tPA Bridging YES: Give the juice! M Hill
0955-1005 tPA Bridging NO: It rarely works! U Fischer
1005-1015 Technology: Tenecteplase (TNK-tPA) and other thrombolytic drugsB Menon
 
1015-1030Coffee Break
 
1030-1140 Session 5: In the angio suite – how to move quickly but safely
Moderators: T Krings, R Budzik
1030-1046 Tips and tricks to speeding up Puncture to Reperfusion Time and getting TICI-3 from the first attempt M Poitin
1046-1102 Technology: Future solutions for dealing with difficult arteries and Distal emboli prevention M Gounis
1102-1112 How do I do EVTMahesh Jayaraman
1112-1122 How do I do EVTMayank Goyal
1122-1132 How do I do EVTJens Fiehler
1132-1140 Discussion and audience participation
 
1140-1300 Session 6: In the angio suite – difficult decision making
1140-1155 M1 occlusion turned to be on top of atherosclerotic disease; what to do?S Yoshimura
1155-1210 Carotid stenosis: When to revascularize/antithrombotic managementM Hill
1210-1230 UNMASK-EVT study resultsG Saposnik
1230-1300 Q&A
 
1300-1335 Lunch
 
1300-1500 ESCAPE-NA1 trials meeting (Trials centres only)
 
1700-1800Cocktails
1800-2100Dinner & Speaker
2100-0000Socializing

Sunday, May 6

Decision Court

These sessions will focus on challenging decisions that physicians could face in real life. Each expert will present a major challenge/ complication that they faced. Other experts will constitute a judge and jury bench that will discuss medical issues around these complications. Audience opinion will be sought using qualitative interactions and opinion polls.
0800-0845 Scenario 1: Older patient at a PSC with high NIHSS and moderate ASPECTS, with proximal occlusion and did not transfer
Judges: A Alexandrov, M Goyal
Lawyers: R McTaggart (against), Dowlatshahi (with)
 
0845-0930 Scenario 2: Patient NOT eligible for tPA presents with aphasia (NIHSS 4), and a small M3 branch occlusion. Neurologist did not refer for thrombectomy.
Judges: J Fiehler, Lise Leth Jeppesen
Lawyers: Charles Matouk (with), L Casaubon (against)
 
0930-1000 Coffee Break
 
1000-1045 Scenario 3: Dominant M2 branch occlusion with NIHSS 7 — “I treated with IV tPA and did not refer to EVT”
Judges: A Demchuk, A van der Lugt
Lawyers: J Fiehler (against), A Alexandrov (with)
 
1045- 1130 Scenario 4: Patient with M1 occlusion but NIHSS only 3: Neurologist did not refer for EVT
Judges: Urs Fischer, Mayank Goyal
Lawyers: Cameron McDougall (against), A Demchuk (with)
 
1130-1215 Scenario 5: Imaging in late time window:
Patient presented at 0700; last seen well at 10 pm. NIHSS of 18. M1 occlusion. I could see the collaterals filling in a single phase CTA and the ASPECTS was not a wipe out. I didn’t bother with CTP but took the patient straight to angio.
Judges:J Wong, D Tampieri
Lawyers: J Rempel (against), M Hill (with)
 
1215-1230Q &A & Thanks

Bon Voyage!

Speakers

  1. Andrei Alexandrov
  2. Mohammed Almekhlafi
  3. Ron Budzik
  4. Leanne Casaubon
  5. Andrew M. Demchuk
  6. Dar Dowlatshahi
  7. Jens Fiehler
  8. Urs Fischer
  9. Don Frei
  10. Matt Gounis
  11. Mayank Goyal
  12. Jim Grotta
  13. Michael D. Hill
  14. Jessalyn Holodinsky
  15. Mahesh Jayaraman
  16. Lise Leth Jeppesen
  17. Noreen Kamal
  18. Timo Krings
  19. Charles Matouk
  20. Cameron McDougall
  21. Ryan McTaggart
  22. Bijoy K Menon
  23. Tom Noseworthy
  24. Michel Piotin
  25. Donatella Tampieri
  26. Aad van der Lugt
  27. S Yoshimura