0223-ISC-brief-global access_WP

HOUSTON — Global stroke experts will gather on Thursday to talk about access to the latest technologies and treatments for strokes. The problem, experts say, is that access in different parts of the world is limited and inconsistent.

“Advances in stroke treatment and prevention are often expensive and available only to people living in special areas in high-income regions,” said Werner Hacke, M.D., Ph.D., senior professor of neurology at the University of Heidelberg in Germany. Hacke co-moderated the American Heart Association/American Stroke Association and World Stroke Organization joint session at the ASA’s International Stroke Conference in Houston.

“Ninety percent of the world’s population has no access or only limited access to any of the advances in stroke care from the last 20 years,” said Hacke, the WSO’s president.

Treatment effectiveness often varies by geography, how quickly patients are identified and how soon urgent medical care is sought. Too few people are capable of recognizing acute stroke symptoms and taking appropriate action, said Ralph L. Sacco, M.D., session co-moderator and a past AHA president.

“We’ve had a lot of success using [the clot-busting drug] tPA for the treatment of acute ischemic stroke, but access to acute therapies remains a problem, even in high-income countries,” said Sacco, chairman of the Department of Neurology at the University of Miami Leonard M. Miller School of Medicine.

Developing acute stroke care protocols across the economic spectrum is important, experts say. M. Patrice Lindsay, Ph.D., of the Institute of Health Policy, Management and Evaluation at the University of Toronto in Canada, will explain the use of the WSO Tool Kit, a resource that’s helping countries at all income levels develop evidence-based stroke care procedures.

Sheila Martins, M.D., a neurologist at the Hospital de Clínicas de Porto Alegre in Brazil, will discuss her treatment approach.

“Dr. Martins has had major success with acute stroke systems in Brazil, although other areas of South America have lagged behind,” Sacco said.

Stroke is particularly common and becoming more so in Eastern Europe, where the European Stroke Organization’s Eastern Europe Project is tackling the problem. ESO president Valerie Caso, M.D., Ph.D., of the University of Perugia Stroke Unit in Italy, will discuss the goals.

Thang Nguyen, M.D., of Ho Chi Min City, Vietnam, and Jeyaraj D. Pandian, M.D., of Punjab, India, plan to describe how stroke patients are treated in their countries.

“Stroke is a rapidly advancing field, but it leaves many people behind,” Hacke said, adding that most regions of the world lack access to basic technology, such as CT scanners. “This session addresses these challenges in stroke care, as well as progress around the world. It will be valuable to practitioners, policymakers, nurses and anybody interested in improving the treatment of acute stroke.”