The 1st Annual Conference of Chinese Stroke Association (CSA) and Tiantan International Stroke Conference (TISC 2015) was held at the China National Conference Center (CNCC) in Beijing from June 26–28, 2015. Many domestic and international scholars and experts who are focusing on cerebrovascular disease discussed the development of CSA, the international cooperation, development strategies, and other issues together. Tens of thousands of people participated in the distinguished gathering and dozens of sessions were involved in the major conference in the field of cerebrovascular disease.
In China, stroke has become the first cause of death and disability. The level of prevention and treatment of stroke needs to be improved and has made a breakthrough in 2014—endovascular treatment. In 2015, New England Journal of Medicine published five clinical randomized studies on endovascular thrombectomy from Holland, Canada, the USA, Europe, Australia, and Spain. The results showed that the recanalization rate and brain tissue reperfusion degree could be significantly improved and neurological outcomes would be better for patients with acute ischemic stroke who met the inclusion criteria after being taken the endovascular thrombectomy. Due to the significant medium‐term efficacy of test group, four studies were terminated ahead of time. Consensus of experts in Europe and the USA pointed out that the evidence‐based medicine listed as grade IA owing to the definite efficacy of this therapy, the significant benefit which outweighed the risks, numerous study population, and data which sources from multiple randomized trials or meta analysis. In the same year, Chinese experts updated the guideline kept ahead of Europe and the USA and formulated “Chinese guideline for the diagnosis and treatment of acute ischemic stroke 2015”. This treatment of acute stroke is a major technological change in the improvement of the effect and the prognosis of patients. However, at present, there are still less than 50 hospitals which can carry out the endovascular thrombectomy and the number of cases is less than 1800 every year. Therefore, it is in urgent need of the extensive technical training in China and steadily standardizes the promotion of this new technology, in order to make more patients in acute ischemic stroke benefit. Dr. Marc Fisher, Chief Editor of journal STROKE, presented at plenary session on Sat. morning.
For the prevention and control of stroke, “Time is brain”! Medical media organizations should publicize emergency knowledge of stroke to the majority of patients and their families, and achieve “two early”: one is that patients with the related symptoms of stroke should arrive the hospital with the qualification of thrombolysis and thrombectomy as soon as possible instead of wait; another is to help patients understand that which technologies can help patients reduce mortality and improve the prognosis, and to clear the good curative effect of thrombolysis and endovascular thrombectomy for ischemic stroke and the benefits which far outweigh the risks. Let patients cooperate with the hospital and make a decision as soon as possible so as to gain valuable time to diagnosis and treatment.
Professor Stephen Davis, President of WSO, had a view on the diagnosis and treatment of stroke then. He believes that there is a huge revolutionary change in the treatment of stroke, which is caused by a blockage of blood flow. Global patients at least about 10% every year (ie, about 200–300 million) are suitable for the endovascular thrombectomy. The important task is to let patients and their families understand the technology and arrive the hospital with the qualification in time to receive the treatment. Professor Davis indicated that endovascular thrombectomy is a great progress and he firmly believed that this technology would get good quality control and check and China must lead the trend of world in thrombectomy. But still, many issues need to be addressed.
The main three big changes in the current international clinical research are as follows: (1) patients with large vessel obstruction were selected, (2) to emphasize the method of mechanical thrombectomy, most patients take the new generation stent device of thrombectomy, and (3) most studies emphasized that the patients should have ischemic penumbra and incomplete necrotic brain tissue. Past researches have shown that although patients achieved the revascularization, the clinical prognosis was not good. Now these studies suggest that a reasonable selection of patients and thrombectomy for the valuable patient can lead to high recanalization rate and the improvement in probability of self‐care among 3 months. The latest research results showed that one patient might obtain the ability to live independently among 3–4 patients, so as to create a good foundation for future treatment!