International Stroke Conference 2008 Preview

iSc Preview | New Orleans Second ‘Chairs’ Choice’ session highlights more cutting-edge abstracts those who are pharmacologists,” said Dr. Hurn, Professor and Vice Chair for Research in the Department of Anesthesiology and a n o t h e r d o n ’ t - m I S S Perioperative Medicine and Director of the session at this year’s conference is Research Center for Gender Medicine at the Friday morning’s “Chair’s Choice Oregon Health and Science University School II: A Last Taste of Research at ISC of Medicine, Portland. “Of that group, some have a passion and 2008.” This oral abstract session complements the “Chairs’ Choice I” session involvement in research. However, it’s clear by presenting top-rated research selected that in a very busy meeting like the Stroke by the Program Committee’s section chairs meeting, there are many individuals who, unless they are actively participating in reand co-chairs. Both sessions will meet in La Louisiane search, may not be exposed to a great deal of A/B, with “Chairs’ Choice I” beginning at the research presented at the conference. The 8:10 a.m. and “Chairs’ Choice II” following intent of the two Chairs’ Choice sessions on the last day is to present scientific research of at 9:50 a.m. interest to everyone at the Co-moderated by Promeeting,” Dr. Hurn added. gram Committee Vice Chair “These sessions will proPatricia D. Hurn, PhD, FAHA, vide a common ground “Chairs’ Choice II” will feawhere all attendees, regardture seven oral abstracts less of whether or not they that the Program Commitare actively engaged in tee doesn’t want attendees research, will be exposed to to miss. some of the most important “The Stroke meeting atfindings across the topical tracts a very diverse group areas of the conference,” of academic and clinical she continued. disciplines. We have those Abstracts are submitted who are clinicians, those Program Committee Vice Chair who are pure scientists, and Patricia D. Hurn, PhD, FAHA to the conference in 19 topic categories, such as experimental ischemia or pathophysiology and thrombosis, and undergo a peer-review selection process. “For example, the research in the category of experimental ischemia is conducted not in humans but at the molecular level in animals or cells,” Dr. Hurn said. “Each of the leaders of the category sections selects one of the abstracts in their field that they think would be most compelling to attendees.” Indeed, Dr. Hurn urged all attendees to make plans to attend Friday’s two Chairs’ Choice sessions. “If people go to no other abstract sessions at the conference, they should make time for these two sessions,” she said. “The future of the clinical care we provide is based in science, and one must be exposed to scientific research whether you are actively involved as a clinician, as a clinicianscientist, or as a non-clinician scientist,” Dr. Hurn continued. “The common thread that links us all is that the future for stroke lies in our research. We want people to attend these sessions so they get the best of all fields.” In all likelihood, attendees will also learn something in these sessions that they can apply to their everyday practice and research, Dr. Hurn said. “In addition, they will get an overview of important research in the field of stroke,” she said. The research to be presented in the “Chairs’ Choice II” session includes: • A report of the findings of the TNK-tPA Reperfusion Stroke Study showing that tenecteplase (TNK) induces faster main coronary artery recanalization and leads to better short- and long-term outcomes than native tPA • An in vitro proof of concept that magnetic resonance-guided focused ultrasound surgery can be used for the treatment of intracerebral hemorrhage • A study looking at age as a factor to consider in making the choice of stenting or surgery for symptomatic carotid artery stenosis • Results of the VECTORS (very early constraint therapy for recovery from stroke) Phase II randomized, controlled trial • Long-term results of a study of endovascular treatment of brain arteriovenous malformations with a prolonged intranidal onyx injection technique • A high-resolution copy number analysis of patients with sporadic and cerebral cavernous malformations • A study of transplantation of adipose tissue-derived stem cells for cerebral ischemia. Symposium to examine relationship between sickle cell and stroke the cOnnectiOn between sickle cell disease and stroke, as well as ongoing research into ways to predict and prevent stroke in patients with sickle cell disease, will be explored in a symposium on the first day of the 2008 International Stroke Conference in New Orleans. The session, titled “Stroke in Sickle Cell Disease: Recent Successes and Ongoing Challenges,” will begin at 9:10 a.m. Wednesday, Feb. 20, in Hall B 2-2. The first of the sympo sium’s four speakers, Heather J. Fullerton, MD, a pediatric neurologist at the University of California, San Francisco, will address the changing demographics of stroke in sickle cell disease. Session moderator Robert J. Adams, MS, MD, Professor of Neuroscience and Director of the Stroke Center at the Medical University of South Carolina, Charleston, said Dr. Fullerton’s presentation will educate attendees on how current practices and research have influenced the demographics of stroke in sickle cell disease and to look at the interplay between pediatric stroke and stroke in older patients with sickle cells disease. “The problem of stroke and sickle cell disease begins at a very early age,” Dr. Adams said. “However, it may change in important ways in adults, and that’s one of the things we are trying to understand. The treatment approaches may also change. The treatment algorithm we developed with the STOP I and STOP II trials is in children.” As the symposium’s second presenter, Dr. Adams will discuss lessons learned in the Stroke Prevention in Sickle Cell Anemia (STOP) trials. The treatment algorithm he and his colleagues developed for the trials began with screening of sickle cell patients by transcranial Doppler ultrasound to detect a high-risk state and then using chronic blood transfusion to prevent stroke in children with sickle cell disease. “It’s not clear how that algorithm will apply to adults. I’ll talk about the design and results of the two STOP trials and reinforce the role of transcranial Doppler in selecting patients for prophylactic treatment. I’ll explain the results in terms of what we were able to do in preventing first strokes,” Dr. Adams explained. “To prevent stroke, we need to look at high-risk subsets to understand who might be at greater risk than others,” he continued. “The second STOP study examined the question of whether a lower risk subset of patients who have been transfused for 30 or more months can safely be removed from transfusion. That trial showed that while there may be some patients who can tolerate removal, 50 percent of patients are back on transfusion within the first year, either because they had symptoms of stroke or their Doppler results reverted to a high-risk category. “The bottom line message is that the transfusion program reduces risk by altering the environment in the short term but does not appear to change the fundamental characteristics of the patients that lead them to be at high risk. Therefore, the next trial most likely will have an active treatment arm to determine whether hydroxyurea is able to maintain a reduced stroke risk state after some initial period of transfusion,” Dr. Adams said. The session’s third speake r, M i c h a e l D e B a u n , M D , MPH, Professor of Pediatrics, Biostatistics, and Neurology at Washington University in St. Louis, will discuss the challenge of small vessel stroke in patients with sickle cell disease. “Small, silent infarcts usually escape clinical detection but show up on MRI and are associated with adverse performance on neuropsych testing,” Dr. Adams said. “Dr. DeBaun will talk about how they relate to large vessel disease. He is conducting a trial of patients with a positive MRI for small vessel stroke, no history of stroke, and a negative transcranial Doppler exam. He is examining the impact of chronic transfusion on patients with small vessel disease.” Finally, James F. Meschia, MD, FAHA, a neurologist at the Mayo Clinic in Jacksonville, Florida, will discuss what is known about genetic predictors of stroke in patients with sickle cell disease. “There has been a lot of progress in genetic research in stroke, and sickle cell is one of the first molecular diseases that has been understood for a very long time on a genetic level,” Dr. Adams said. “One of the questions looked at recently is that in addition to the hemoglobin S mutation, are there other genetic abnormalities that will help determine which patients have the highest risk of stroke?”

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