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WSC 2022 | Outcome prediction after stroke treatment

Urs Fischer, MD, Basel University Hospital, Basel, Switzerland, and Yvo B. Roos, MD, PhD, Amsterdam University Medical Center, Amsterdam, The Netherlands, discuss factors impacting outcome after stroke and efforts to predict how a patient will respond to endovascular therapy (EVT). Prof. Roos notes that for both intravenous thrombolysis (IVT) and thrombectomy, timing is crucial. All trials have tried to get both treatments to the patients as quickly as possible, and if there is any delay with giving thrombectomy, IVT must start immediately which will help the final outcome for the patient. For those treated in the late time window, new data from the MR CLEAN-LATE trial has defined selection criteria based on the presence of collateral flow on CT angiography. Patients with collaterals were shown to benefit from thrombectomy when treated 6-24 hours from symptom onset, broadening the previous eligibility criteria. Regarding outcome prediction, scores are limited by their inability to rule out that a given patient might benefit from a given intervention. Instead, prediction tools are needed that definitively show which patients will not benefit from treatment and consequently, the rest of the patients are treated. This interview took place at the World Stroke Congress 2022 in Singapore.

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Prof. Fischer reports the following disclosures:
-research grants from Medtronic (BEYOND SWIFT, SWIFT DIRECT) and from Stryker, Rapid medical, Penumbra and Phenox (DISTAL).
-consultancies for Medtronic, Stryker, and CSL Behring (fees paid to institution).
-participation in an advisory board for Alexion/Portola and Boehringer Ingelheim (fees paid to institution).