ALL-OF-US (Alliance, Innovation, and Transformation for Untreated Stroke) Network Symposium 2024 Recap
Global stroke experts gathered in Bangkok to address the state of mechanical thrombectomy (MT) and its future in Southeast Asia.
Key Highlights:
- I presented data from the 2020 MT GLASS study showing disparities in thrombectomy access:
- Thailand: 2.76% access in 2020.
- Singapore: 40%.
- Vietnam: 6.56%.
While 2023 estimates from Dr. Nijasri Suwanwela show ~1,500 thrombectomies annually (4% of cases), substantial gaps remain compared to the ~900 cases in 2020 (2.76%). Almost 10x less access than world leading countries. (Singapore, USA, Australia)
- Dr. Tudor Jovin highlighted new data supporting broader treatment for large core infarcts accounting for up to 20% of large vessel occlusion stroke, suggesting life-saving therapy for over 100,000 patients worldwide and reinforcing the “just remove the clot” approach. (Trials : RESCUE-Japan, ANGEL ASPECTS, SELECT2, TESLA, TENSION, LASTE)
- Dr. Ashutosh Jadhav shared the ASSIST Registry data and other recent publications, confirming that combined techniques (stent retriever with aspiration) yield better first-pass reperfusion rates than aspiration or stent retriever alone. Early switching to the combined technique also resulted in better reperfusion rates than persisting with the same technique.
- Dr. Sirintara Pongpech emphasized Thailand’s preference for aspiration-first techniques due to reimbursement limits, contrasting with Singapore, which leads the world in thrombectomy access with higher usage of combined techniques.
Looking Ahead:
Global experts, including Dr. Alexandra Czap, Dr. Sombat Muengtaweepongsa, Dr. Naoki Kaneko, Dr. Adrian Burgos and Dr. Yasushi Matsumoto, discussed potential new technologies to improve MT access, including:
- Leveraging AI diagnostics for early triage using non-contrast CT.
- Utilizing point-of-care large vessel stroke detection for faster patient transfers. Joshua Bernstock MD, PhD
- Collaborating with global core labs to enhance clinical trials and imaging platforms to foster innovation in Asia. David Liebeskind #brainstorme
The symposium emphasized the importance of collaboration, education, and innovation in improving stroke care across Southeast Asia. The ALL-OF-US Stroke Network remains dedicated to building sustainable solutions for broader MT access.
Special thanks to Chulalongkorn University Chula Stroke for hosting. All-of-US Stroke Network
#AllOfUsStrokeNetwork
