G QUE IN E HNI LOW UR TEC H FOL S FAIL e 15 ITC AS ag SW IRST-P n to p F Tur
May 2025 Issue 58
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Featured in this issue:
T.J. Miller discusses life as an AVM survivor
Profile Johanna Fifi
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Is combining embolisation and drainage the next step in cSDH treatment? page 16
ECONSENT
Electronic consent demonstrates potential to overcome “key barrier” in stroke trial recruitment Post-hoc analyses of a large, randomised clinical trial have revealed the potential advantages associated with electronic informed consent (eConsent) in acute ischaemic stroke studies, including increased enrolment rates and improved adherence to consent documentation.
analysis of eConsent adoption within the MOST trial, a Phase 3 trial evaluating the potential benefits of two different bloodthinning medications alongside standard-of-care intravenous thrombolysis (IVT) in adult ischaemic stroke patients. Late-breaking data from MOST were presented at last year’s International Stroke Conference (ISC) and have been published in full in the New England Journal of hese findings were recently published in the journal Medicine, ultimately revealing no significant 90-day Stroke by lead author Iris Davis (University of clinical benefits with either argatroban or eptifibatide Cincinnati, Cincinnati, USA), corresponding as compared to placebo treatments. author Christopher Streib (University of Minnesota, For their subsequent analyses of MOST, Davis Minneapolis, USA), and colleagues. et al reviewed study databases to ascertain whether “EConsent […] was associated with higher individual participants were enrolled using conventional paper site enrolment, higher remote consent rates, and consent forms or eConsent. Additionally, they improved consent documentation adherence, over paper determined whether the participant or their legally consent,” Davis et al write, concluding their paper. “Our authorised representative provided informed consent study outlines the potential advantages of eConsent in person, or if they were located remotely. Participants adoption in future acute ischaemic stroke clinical trials Top to were then assigned to one of four informed consent and stroke research networks.” bottom: modalities: paper (in person), paper (remote), eConsent Davis et al begin their paper by noting that obtaining Iris Davis, timely informed consent represents a “key barrier” in Christopher (in person), and eConsent (remote). The authors also note in their Stroke publication that study sites had the freedom acute ischaemic stroke clinical trial recruitment—and, Streib to use paper consent or eConsent for each enrolment. while eConsent may have the capacity to optimise Outlining the results of their research, Davis et al state recruitment by enabling electronic delivery and that eConsent was utilised for 173 (93 in person, documentation of the informed consent process, it remains both “limited and understudied” in these types of trials. The researchers therefore set out to conduct a post-hoc Continued on page 2
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Endarterectomy retains favour with CX audience page 19
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CEA is carotid gold standard
Disparities in European stroke care need “urgent attention” despite recent progress AS PER DATA FROM THE Stroke Services Tracker (SST)— a monitoring tool evaluating progress towards Stroke Action Plan for Europe (SAP-E) targets—improvements are being made with regard to stroke care planning and treatment access, but persistent disparities requiring “urgent attention” remain at play. Data launched on European Stroke Awareness Day (13 May) indicate “encouraging progress” coupled with “serious inequalities” across the continent, say the European Stroke Organisation (ESO) and the Stroke Alliance for Europe (SAFE). A total of 47 countries contributed to the latest dataset, providing the “most comprehensive picture” to date of stroke care across Europe. The findings—based on data from 2023— show improvements in national planning, emergency treatment and prevention, but also indicate that patients still face “major challenges” in accessing the care, rehabilitation and follow-up they need. “It is unacceptable that [...] we still see such wide disparities in access to stroke unit care, early rehabilitation and life-after-stroke support,” said SAFE director general Arlene Wilkie. “Stroke survivors need holistic and continuous care. We call on all national governments and policymakers to do better in providing the essential services required for all those affected by stroke.”