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/Introduction | M 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 trials | A van der Lugt |
| 1430-1500 | Coffee Break
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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 NIHSS | A Demchuk |
| 1600-1605 | Case presentation #3 | |
| 1605-1630 | Extending boundaries for EVT (distal occlusion trials) | B Menon |
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| 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
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| 1930-2130 | Dinner
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| 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 algorithms | J Holodinsky |
| 0820-0830 | Destine | N Kamal |
| 0830-0840 | Technology: NeuroAnalytics | R Hamilton |
| 0840-0845 | Q and A
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| 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
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| 0905-0910 | Technology: CLOTBUSTER to TRUST Trials | A Alexandrov
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| 0910-0915 | Q and A | |
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| 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? | |
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| 0945-1015 | Session 4: Medical treatments before EVT
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| 0945-0955 | tPA Bridging YES: Give the juice! | M Hill
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| 0955-1005 | tPA Bridging NO: It rarely works! | U Fischer |
| 1005-1015 | Technology: Tenecteplase (TNK-tPA) and other thrombolytic drugs | B Menon |
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| 1015-1030 | Coffee Break | |
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| 1030-1140 | Session 5: In the angio suite – how to move quickly but safely | |
| Moderators: T Krings, R Budzik
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| 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 EVT | Mahesh Jayaraman |
| 1112-1122 | How do I do EVT | Mayank Goyal |
| 1122-1132 | How do I do EVT | Jens Fiehler |
| 1132-1140 | Discussion and audience participation | |
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| 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 management | M Hill |
| 1210-1230 | UNMASK-EVT study results | G Saposnik |
| 1230-1300 | Q&A | |
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| 1300-1335 | Lunch | |
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| 1300-1500 | ESCAPE-NA1 trials meeting (Trials centres only)
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| 1700-1800 | Cocktails | |
| 1800-2100 | Dinner & Speaker
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| 2100-0000 | Socializing | |
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.
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| 0800-0845 | Scenario 1: Older patient at a PSC with high NIHSS and moderate ASPECTS, with proximal occlusion and did not transfer
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| Judges: | A Alexandrov, M Goyal
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| Lawyers: | R McTaggart (against), Dowlatshahi (with) | |
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| 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) | |
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| 0930-1000 | Coffee Break | |
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| 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) | |
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| 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) | |
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| 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) | |
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| 1215-1230 | Q &A & Thanks | |
Bon Voyage!
Speakers
- Andrei Alexandrov
- Mohammed Almekhlafi
- Ron Budzik
- Leanne Casaubon
- Andrew M. Demchuk
- Dar Dowlatshahi
- Jens Fiehler
- Urs Fischer
- Don Frei
- Matt Gounis
- Mayank Goyal
- Jim Grotta
- Michael D. Hill
- Jessalyn Holodinsky
- Mahesh Jayaraman
- Lise Leth Jeppesen
- Noreen Kamal
- Timo Krings
- Charles Matouk
- Cameron McDougall
- Ryan McTaggart
- Bijoy K Menon
- Tom Noseworthy
- Michel Piotin
- Donatella Tampieri
- Aad van der Lugt
- S Yoshimura
