ESC2015 Interview, Highlights and Key Aspects
presented by Conference Chairman Prof. M. G. Hennerici

Highlights at the 24th European Stroke Conference in Vienna 2015

Interventional thrombectomy, repair processes in the brain:

„Future strategies on a top level of research!“
Vienna. The 24th European Stroke Conference (ESC) took place in Vienna from 13 to 15 May 2015 with great success. At one of the largest stroke conferences worldwide participants from more than 80 countries met to discuss current issues in stroke treatment as well as in the interdisciplinary research and clinical collaboration in the medical fields concerned with stroke and to exchange new insights in the Congress Centre of the Reed Exhibition Hall in Vienna.

A controversial debate was held at a top notch level on new data concerning interventional thrombectomy related to acute ischemic stroke which could complement the iv thrombolysis in selected patients and which offers great chances, but also risks for the patients concerned.
‘Several current studies consistently prove the benefit of a complementing interventional thrombectomy after evidence of an occluded large cerebral artery, but they also raise numerous questions for implementation into the clinical management”, ESC Congress President Prof. Dr. med. Michael G. Hennerici, Director of the Neurological Clinic of the University Hospital Mannheim, emphasized.
In the critical argument in the symposium „Endovascular treatment of acute stroke: News and perspectives were“ – in particular the tentativeness of data acquisition of all studies which were terminated at an early stage after the initial presentation of MR. CLEAN and thus were incomplete – unresolved issues relating to patient selection and the missing analysis of imaging diagnostics with very heterogeneous inclusion criteria. All attendees and interested persons are invited by the Scientific Journal ‘Cerebrovascular Diseases’ (accompanying the ESC) to participate in a discussion. www.karger.com/Article/FullText/433569

Groundbreaking studies to enable the reorganisation of the brain after a cerebral infarction will be an important key topic for the next decade in stroke research.
Experimental studies allow a transnational transmission into clinical research for the first time and besides an improved comprehension of the extremely complex repair processes of the brain also with adults and at a higher age – open up new strategies in the management of early rehabilitation. On the basis of experimental and clinical pilot studies strategies for useful implementation possibilities were discussed. The question was posed how the far more effective plasticity of the brain and its ability to compensate lesions temporarily or permanently – compared with previous knowledge   – could be integrated in the treatment strategies.
At the mutual symposiums of the “European Stroke Research Foundation” ESRF und the ESC “The promise of neurorecovery from stroke: From molecules to networks” and “Penumbra reperfusion” as well as the shared meeting with the European Federation of Neurorehabilitation EFNR and the ESC future strategies at top quality research were discussed.

Subject of the expert discussions were further new findings in the field of stroke after-care.
Therapeutic robots, neuro-modulatory simulation techniques and computer assisted, cognitive therapy systems can – following the acute medical treatment – improve the areas of motoric skills, awareness, speech and speaking, swallowing and brain organized abilities. “Indeed we have had exceptional successes“, explains Prof. Dr. med. Volker Hömberg, Head of the Neurological Clinic at the SRH Bad Wimpfen, who at the same time alerts that too-high hopes are raised: “Decisions should be made in spezialized centres, in which cases they can be useful and in which areas there are possibilities for improvement.”
In addition to numerous innovative issues the Viennese ESC showed off with several new meeting styles which were well received by the participants: The “Stroke news today” offered current topics for discussion in concentrated form – for example “Inflammation and stroke, Botulin toxin and stroke treatment, Stroke and oncology” as well as “Nutrition and dysphagia.”
Controversial discussion points came to the table and were debated vividly at special “Expert Roundtables.” Another communication forum discussed therapeutic standards “beyond guidelines” from different perspectives, posing the question as to what extent “Large clinical trials” and meta-analysis can still be up-to-date.

Current innovations with surgical procedures were presented by excellent neurosurgeons from Japan, Europe and North America. Foundations were the latest experimental and clinical study results concerning pathobiology, natural history and pharmacological as well as interventional neurosurgical therapies for the “Management of ruptured and unruptured aneurysms.” Later on discussions were held in the new meeting and communication style of the “Expert Roundtable” at which the question regarding the management beyond safe guidelines was raised as well.

New aspects of the prevention of stroke with an ageing population, concept-individualized, “tailored“ and also personalized therapy as well as prevention, management in the acute state and follow-up measures with elderly patients with complex comorbidities were important focal points – as well as the increasing occurrence of stroke at a younger age – were discussed in the regular annual symposium of the European Society of Cardiology and the ESC: “Heart and Brain: the concept of stress and emotions” .
Since succeeding to reduce the consequences and complications of acute stroke in the industrialized nations drastically by implementing the specific therapy of iv thrombolysis and stroke unit management, a decrease by up to 80% in stroke occurrences and by up to 60% in cardio/vascular/stroke diseases could be gained through changes in lifestyle and better modulation of risk factors. The mortality rates in the US and Europe could also be reduced by a third. At a mutual event of the Pan-American Federation of Neurological Societies and the ESC it was obvious that the underdevelopment in Central and South America has caught up in the meantime.

On the last day of the congress a further highlight was the presentation of the 11th „ Wepfer
Award”, the ‘OSCAR of the ESC’ to Prof. Ralph Sacco, USA and the “Special Lecture” of world-famous stroke scientist Walter J. Koroshetz, M.D., Director of the National Institute of Neurological Disorders and Stroke (NINDS), the most renowned US-American Institute for research of cerebral and neurological disorders.

On the last day of the congress for the first time 21 young scientists from 15 countries could be awarded for their own best assessed research studies and 20 Junior Investigator Travel Grants could be presented on behalf of the “European Stroke Research Foundation” (ESRF) at the ESC in Vienna: www.eurostroke.eu introduces the award winners.

Prof. Hennerici who co-founded the ESC in 1990 emphasized that the exchange of ideas and Know-how amongst experienced physicians of the most varying specialties, scientists from experimental and clinical research groups as well as international junior researchers will be continued next year at the 25^th “European Stroke Conference” (ESC) taking place in Venice from 13 to 15 April 2016.