Speaking on wide range of topics, we join Prof. René CHAPOT from LINNC Paris 2021, we begin the discussion with stroke treatment and the question of medical therapy before endovascular therapy in stroke treatment. Speaking about nerinetide the ESCAPE-NEXT study, Prof. CHAPOT discusses the question of whether this agent could be efficacious in stroke victims who do not get other forms of lysis such as alteplase and what impact this could have on stroke treatment in general. More distal thrombectomies were also discussed as the techniques and experience evolve in the use of newer devices.
Turning to aneurysms, he notes that patient selection and the willingness to treat aneurysms is increasing along with the choice in devices. But, Prof. CHAPOT asks, should we treat everyone and every aneurysm? Do we fully understand our ability to treat and the nature of the risks involved when we make our decision? Why it is critical to better understand the stability over time when using these devices, a study Prof. CHAPOT is currently involved in.
Concerning bleeding risk, could the new molecules used in antiplatelet therapy be too efficient? How do we establish thresholds concerning minimum and maximum of efficiency?
In the future treatment of AVMs, Prof. CHAPOT explains that while embolization has decreased due to several factors including the Aruba study or surgical techniques, his own current experience with transvenous embolization techniques is promising though the complications in using venous access to treat AVMs is challenging.