Abstract
Welcome to the 1st issue of the European Stroke Journal for 2018, the third year of the journal. As we write this editorial, the ISC in Los Angeles has just taken place and with trial results that further significantly enhances the treatment possibilities of stroke – the confirmation that patients with salvageable brain tissue benefit from thrombectomy up to 24 hours after the onset. Another milestone in stroke therapy has been reached, thanks to the vision and endurance of a team of brilliant researchers.
A major step forward, but is “Victory Won”? Unfortunately not, when it comes to the translation of scientific advances into clinical practice. A recent survey of the ESO (currently in publication pipeline) has shown that implementation of even basic stroke services in Europe is uneven and progress is slow. Implementing the advanced therapies will be even more challenging. At the upcoming ESOC in Gothenburg in May, the European Stroke Action Plan will be launched, setting specific targets from 2018 to 2030 for stroke in Europe. It will be one of ESO’s most important missions in the near future to provide the leadership required to reduce the burden of stroke in Europe. A workshop on the Action Plan will take place in Munich March 22-23 and will be webcasted to ensure maximal participation in the process. Check out the ESO website for more details.
An important part of the upcoming Action Plan is the identification of prioritized areas for research and development. The long list of items will demonstrate that there are still many areas in need of research and discoveries, in prevention and in all areas along the chain of care in stroke. Think only of the lack of major advances in the treatment of intracerebral hemorrhage compared to acute ischemic stroke.
The present issue of the European Stroke Journal contribute to progress in several areas. The series of ESO Guidelines (one of the backbones of the journal) continues with recommendations on glycaemic management in acute stroke. A report from the SITS-MOST registry advances our knowledge on how to deal with minor stroke due to large vessel occlusion – intervene or not? Another SITS report addresses the grey segment of how to deal with patients falling between product label and guideline recommendations on use of thrombolytic therapy – a common clinical dilemma. A Swiss report provides new data on endovascular and thrombolytic therapy in ischemic stroke due to cervical artery dissection. Combines trial endpoint issues are discussed by our Scottish colleagues. Prediction models after carotid revascularization procedures has been subject to an important systematic review. Our UK colleagues provide an elegant report on the use of register data to estimate the economic burden of stroke, breaking new grounds in this field. A Swedish report reminds us that stroke is the 2nd largest killer globally and that palliative care is an import area for improvement in stroke – much more challenging we would say than palliative care for cancer (which has a more predictable course). Finally, Eivind Berge and colleagues report on European collaborations in stroke research. Are they feasible? It is up to the readers to remove the question mark of the title, but the potential is clearly there.
I trust the vast majority of us will meet in Gothenburg in May for the ESOC, and I hope to meet many of you also in Montreal for the World Stroke Congress in October. Till then, continue to read our journal, be active in submitting your best science, and kindly help us by serving as willing reviewers – we need you. The start of 2018 has been great for stroke. Let’s make 2018 one of the best years ever when synergies come together and produces magic – the case of stroke needs our full efforts. Stay tuned on the ESJ and the ESO channels.
Bo Norrving, Editor-in-ChiefDidier Leys, Vice Editor