Stroke Society Australasia in pictures

Joanne Murray and Coralie English

Valerie Pomeroy

Stephanie Ho and Brenda Booth

Sandy Middleton and Simeon Dale  

Chris Levi and Jane Maguire

David Howells and Milos Pekny

Atte Meretoja

Nadine Andrew and Monique Kilkenny

Leonid Churilov Florey Statistician, Elise Cowley and Tina Soulis from NTA

Bernard Yan and Bruce Campbell

Ian Mosely

Lisa Walker, Sue Mosely, Sandra Petrolo, and WenWen Zhang

Tissa Wijeratne, Julie Bernhardt Director of the AVERT trial and Erin Godeke

Mhairi Macrae, Neuroscientist University of Glasgow

Fiona Ellery from NTA and AVERT Trial with Carmen Lahiff-Jenkins from IJS

Mark Longworth Smartstrokes, Richard Lindley SSA organiser and Dennis Crimmins

The WSO has a new website...

The WSO has a new website

http://www.world-stroke.org/

If you're having trouble with membership access to the journal please contact me: carmenl@unimelb.edu.au

Stroke Society Australasia 2012; it begins.

This week is the Stroke Society Australasia Meeting in Sydney incorporating Smart Strokes, IJS will be in attendance keeping you up to date. Andrei Alexandrov will be there speaking on his imaging 'helmet', Val Pomeroy on Neurorehabilitation, Rustam Al-Shahi Salman on mechanisms of intracerebral and subarachnoid haemorrhage, and Christian Stapf whose interests are brain vascular malformations and other conditions predisposing to intracranial haemorrhage. Caroline Watkins will be be talking about stoke service development. Stephanie Ho stroke survivor and Noel Hayman, Queensland Australian of the Year 2011 who works in Indigenous Health.

Last year IJS collected a fabulous series of interviews from SSA.

Werner Hacke

Argye Hillis

Elizabeth Holliday

Susan Hillier

Jocelyn Bowden

Karlea Kremer

Michelle McDonnell

Timothy Kleinig

Protocol for the perfusion and angiography imaging sub- study of the Third International Stroke Trial (IST-3) of alteplase treatment within six hours of acute ischaemic stroke.

Joanna Wardlaw, Reudiger von Krummer, Trevor Carpenter, Mark Parsons, Richard Lindley, Geoff Cohen, Veronica Murray, Adam Kobayashi, Andre Peeters, Francesca Chappell and Peter Sandercock.   

Abstract
Rationale: Intravenous thrombolysis with recombinant tissue plasminogen Activator (rt- PA) improves outcomes in patients treated early after stroke but at the risk of causing intracranial haemorrhage. Restricting rt-P A use to patients with evidence of still salvageable tissue, or with definite arterial occlusion, might help reduce risk, increase benefit and identify patients for treatment at late time windows.
Aims: To determine if perfusion or angiographic imaging with CT or MR help identify patients who are more likely to benefit from rt-PA in the context of a large multicentre randomised trial of rt-PA given within six hours of onset of acute ischaemic stroke, the Third International Stroke Trial (IST-3).
Design: IST-3 is a prospective multicentre randomised controlled trial testing rt-PA (0.9mg/kg, maximum dose 90mg) started up to six hours after onset of acute ischaemic stroke, in patients with no clear indication for or contraindication to rt-PA. Brain imaging (CT or MR) was mandatory pre-randomisation to exclude haemorrhage. Scans were read centrally, blinded to treatment and clinical information. In centres where perfusion and/or angiography imaging were used routinely in stroke, these images were also collected centrally, processed and assessed using validated visual scores and computational measures.
Study Outcomes: The primary outcome in IST-3 is alive and independent (Oxford Handicap Score 0-2) at 6 months; secondary outcomes are symptomatic and fatal intracranial haemorrhage, early and late death. The perfusion and angiography study additionally will examine interactions between rt-PA and clinical outcomes, infarct growth and recanalisation in the presence or absence of perfusion lesions and/or arterial occlusion at presentation. The study is registered ISRCTN25765518. 

Coming to IJS.

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NeuroThera® Efficacy and Safety Trial – 3 (NEST-3): a double-blind, randomized, sham-controlled, parallel group, multicenter, pivotal study to assess the safety and efficacy of transcranial laser therapy with the NeuroThera® Laser System for the treatment of acute ischemic stroke within 24 h of stroke onset

Rationale Transcranial laser therapy is undergoing clinical

trials in patients with acute ischemic stroke. The NeuroThera

® Efficacy and Safety Trial-1 was strongly positive for

90-day functional benefit with transcranial laser therapy,

and post hoc analyses of the subsequent NeuroThera® Efficacy

and Safety Trial-2 trial suggested a meaningful beneficial

effect in patients with moderate to moderately severe

ischemic stroke within 24 h of onset. These served as the

basis for the NeuroThera® Efficacy and Safety Trial-3 randomized

controlled trial.

Aim The purpose of this pivotal study was to demonstrate

safety and efficacy of transcranial laser therapy with the

NeuroThera® Laser System in the treatment of subjects diagnosed

with acute ischemic stroke.

Design NeuroThera® Efficacy and Safety Trial-1-3 is a

double-blind, randomized, sham-controlled, parallel group,

multicenter, pivotal study that will enroll 1000 subjects at up

to 50 sites. All subjects will receive standard medical management

based on the American Stroke Association and

European Stroke Organization Guidelines. In addition to

standard medical management, both groups will undergo

transcranial laser therapy procedure between 4·5 and 24 h of

stroke onset. The study population will be randomized into

two arms: the sham control group will receive a sham transcranial

laser therapy procedure and the transcranial laser

therapy group will receive an active transcranial laser

therapy procedure. The randomization ratio will be 1:1 and

will be stratified to ensure a balanced subject distribution

between study arms.

Study Outcomes The primary efficacy end point is disability

at 90 days (or the last rating), as assessed on the modified

Rankin Scale, dichotomized as a success (a score of 0–2) or a

failure (a score of 3 to 6).