EAN 2025 | The Stroke Action Plan for Europe: goals and current progress

The Stroke Action Plan is indeed a plan that has been published. It follows the Helsingborg Declaration and this plan has been developed by a large group of experts in order to establish the priorities for stroke implementation between 2018 and 2030. So we are already getting close to 2030. So we are in the last five years of this plan. This plan established very important goals. So the goal to have at least 90% of patients admitted to stroke units. The goal to have almost all patients with access to endovascular treatment and intravenous thrombolysis with access to reperfusion therapies for acute ischemic stroke. Also to have certain rates of treatments which were defined at the time according to the available data, but these targets are really evolving targets, so probably what was already established in the plan is already outdated and that’s why a new update of this plan is also being about to be published, it’s being written and it’s about to be published this update because of course all these targets are evolving, especially this question about the rates of treatments. Since the eligibility criteria are changing, there are new trials that expand the indications both in intravenous thrombolysis and endovascular treatments. These are definitely evolving targets. We also know that the incidence of stroke is rising, the population is aging, so there are a lot of reasons for us to be prepared in order to even improve these rates, even for countries that already seem like the benchmark for high rates. Probably this is already very conservative because the actual targets should be higher. And if we collect data from registries and from several studies that have been looking into this specific aspect, so how many patients should be eligible for things like endovascular treatment, and probably rates almost 40% of patients have large vessel occlusion, so we should be prepared in the future, in the near future, to be treating even many more patients and even targeting higher rates of treatments. It is important to note that these treatments are very cost-effective and that was also something we discussed at the session. Both intravenous thrombolysis is very cost-effective because the reduction that it is associated with intravenous thrombolysis in terms of disability will return the benefit to the society, also in terms of financial costs of the disability, nursing homes, rehabilitation, and so on, and the same for endovascular treatment, it is very cost-effective, and so there is no reason in terms of financial limitations not to provide these treatments, of course, it needs an investment, but it will return to the society not only in better health and better quality of life for people but also in actually less costs for the society in the long term because disability and death have a very high cost to the society. So we all should give this information and as stroke physicians and representatives also of patients in terms of what is scientific societies and professional societies, we all should have this responsibility of providing this information on how effective these treatments are and how important it is that they are provided to all people that may be eligible. And so we do need to make this effort as a society in order to be able to provide these treatments and to guarantee that these treatments are provided with high quality and timely so that the effect is the maximum. And this was mostly what we have been discussing, of course, there are specific gaps that are to be tailored and need tailored measures in terms of reducing these problems per year, so could be infrastructure, technology, could be the reimbursement, could be the lack of professionals, could be the lack of equipment to diagnose large vessel occlusion or the protocols, the intra-hospital protocols, the emergency protocols, could be also limited public awareness, so patients just come too late. But we do have to analyze this specifically in each country and to target specifically each of these barriers. But overall, the message is that we really should make this effort in order to guarantee that these treatments are accessible to all the eligible patients.

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