Mario Muto, Neuroradiology, Antonio Cardarelli Hospital, Naples, Italy, and course director of the Naples Stroke Meeting (18–19 June 2012) tells NeuroNews about the importance of cooperation between diagnostic neurologists and interventional neuroradiologists and that better clinical results can be obtained when medical and endovascular therapy are combined.
As the course director, can you please tell NeuroNews readers what the broad goals of the Naples Stroke meeting are?
There are many differences in the numbers of acute ischaemic stroke patients treated and variations in the type of treatment they receive, from country to country and city to city, and this depends mostly on the different organisation models. Neurologists play a key role in admitting and managing acute ischaemic stroke patients, and for this reason, it is also important to show them the improvements seen in endovascular treatment.
What are the three most important things that a delegate will learn about the latest developments in stroke from the scientific programme of the meeting?
Delegates will learn about the importance of i) the organisation model ii) the importance of co-operation between diagnostic neurologists and interventional neuroradiologists and iii) that better clinical results can be obtained when medical and endovascular therapy are combined.
You are co-ordinating a session on hands-on training on the different devices for endovacular stroke treatment. What are the strengths and weaknesses of the following devices: Trevo; Solitaire; Penumbra, New Catch and Revive?
The concept behind these devices is often similar (with the exception of Penumbra in which there is the additional association of thrombo-aspiration) but probably the radial force of each system is different. Training with these devices and taking into account the learning curve are also important. So far, the experience reported by different centres has evolved along with the improvement of technology, so that the capacity to capture the thrombus has changed in the years. The radial force of the system is important to keep the thrombus within the net of the stent. It is not possible to say in an absolute way at this point if one stent retriever system is superior to another one.
In your view, what are the three interesting papers which have been published recently which have changed stroke management?
There are several published papers and also trials that are still ongoing (such as the Mr CLEAN, Synthesis, IMS III, EFMINT, River III) which have demonstrated, or are setting out to demonstrate, better results of stroke therapy with medical and endovascular therapy, but we lack an accepted randomised controlled trial. Such a trial that is not so easy to organise and perform on this topic.
What is your key message to neurointerventionists in the field regarding endovascular stroke treatment?
We know that the brain is not the heart, but the aspiration to carry out the same mechanical recovery for vessels in the brain is really high.