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Discussing study results

Exclusive Principal Investigators Interviews – Discussing their study results


PI Sara Mazzucco interviewed by Marie-Luise Mono at #ESOWSO2020 In a meta-analysis, Dr Sara Mazzuco from Oxford University found that Patent Foramen Ovale (PFO) was associated with an excess risk of recurrent stroke in the older age group (>=65 years) diagnosed with cryptogenic TIA/stroke on medication alone (OR=2.26, 95%CI=1.36-3.75, p=0.02). Larger PFO was associated with an increased risk of stroke recurrence in both the OXVASC cohort (OR=2.87; 1.05-7.87) and in the pooled analysis of 2 inclusive cohorts (OR=2.32; 1.22-4.43) but not in an analysis of 4 highly-selected cohorts (OR= 1.12; 0.64-1.97). Her findings suggest that evaluation of large PFO closure in older patients with cryptogenic TIA/stroke might be warranted.


Systemic ECG monitoring improves detection of undiagnosed Atrial Fibrillation (AF) in stroke survivors but its impacts on stroke prevention in addition to standard of care ECG monitoring in-hospital is unknown. The ‘Impact of standardized MONitoring for Detection of Atrial Fibrillation in Ischemic Stroke (MonDAFIS)’ study will provide new evidence from 3’470 randomized acute stroke patients in 39 stroke units in Germany on the value of systematic ECG monitoring in-hospital on long-term stroke prevention beyond the mere detection of undiagnosed AF.


‘Direct Transfer to Endovascular Center of Acute Stroke Patients with Suspected Large Vessel Occlusion in the Catalan Territory’: Do acute stroke patients with RACE scale-based suspicion of LVO has a more favourable outcome when transferred directly to an Endovascular Center, as compared to standard transfer to closest Local Stroke Center? Results of the 1’401 patients finally included in the trial will be presented.


Long-term reduced arm function after ischaemic stroke is common and may be improved by Vagus Nerve Stimulation (VNS) paired with rehabilitation. VNS-REHAB compares the effectiveness of vagus nerve stimulation (VNS) paired with intense rehabilitation with sham stimulation and intense rehabilitation – the control. VNS paired with intense rehabilitation was safe and resulted in clinically meaningful improvements in motor function when compared with control in people with moderate to severe arm weakness at least 9 months after an ischaemic stroke.

Genetic studies on ischemic stroke and intracranial aneurysms

Martin Dichgans interviews Mark Bakker and Laura Ibanez on their landmark studies in the field of stroke genetics.
In the  study by Dr. Ibanez and colleagues thy have explored genes associated with early neurological outcome in patients with ischemic stroke, while Dr. Bakker and colleagues have identified 17 loci that are associated with the presence of intracranial aneurysm, including 11 novel ones.


Although rapid endovascular treatment (EVT) in well selected patients is very effective, some patients may experience early reocclusion of the treated artery, and others intracranial hemorrhage. Dr van de Graaf and his colleagues are performing a randomized trial of EVT patients (with or without preceding intravenous thrombolysis), adding either aspirin or two different doses of heparin (low dose, moderate dose) during the EVT. He now presents the first results, in particular the finding that the moderate dose heparin arm of the study had to be stopped because of an increased hemorrhage risk.

MRI based risk score for ICH

Prevention after an ischemic stroke usually includes treatment with antithrombotic drugs (antiplatelets, anticoagulation), but this carries a risk of intracranial bleeds. Prof Werring and colleagues show that their new scores using MRI (including assessment of cerebral microbleeds) can improve the prediction of such bleeds, therefore potentially improving safety of secondary prevention.


Long-term follow-up of UK participants of the ASCOT trial (‘Anglo-Scandinavian-Cardiac-Outcomes-Trial’) showed that better blood pressure control during the trial years (1998-2002) by an amlodipine-based therapy lowered stroke risk for up to 20 years.

Blood pressure after thrombectomy: Multicenter Analysis

The optimal hemodynamic management after endovascular treatment is yet to be determined. In this interview, Sreeja Kodali discusses with Else Sandset her results on a retrospective analysis of 2500 patients with acute ischemic stroke treated with thrombectomy. In this large multicentre cohort study, Kodali and colleagues were able to identify several blood pressure trajectories and their differential association with functional outcome at 90 days.

Global impact of COVID-19: the collateral damage on stroke care

In this interview, Professor Raul Nogueira, a neurologist from Emory University (US) explains his observations from analysing global data on COVID-19 and stroke care from 187 centres across 40 countries and 6 continents. The pandemic has evidently led to collateral damage to stroke services worldwide. Alarming trends have been observed across the globe: a reduction in the number of stroke hospitalisations, mechanical thrombectomy, intravenous thrombolysis and coiling for ruptured aneurysms. Dr Nogueria conveys his key messages to stroke physicians delivering stroke care during this unprecedented pandemic.