A scientific-practical conference on the endovascular treatment of heart attack and stroke: “Innovative X-ray endovascular technologies in the treatment of chronic and acute disorders of cerebral circulation” was held on 21 and 22 December 2018 in St. Petersburg, Russia, where in the last three years the treatment of these diseases has increased by 400%.
The conference was organized by the Russian Scientific Society of specialists in endovascular diagnosis and treatment and was an opportunity for many experts from around the world to discuss and exchange information on current problems of endovascular treatment of chronic and acute disorders of brain circulation.
The discussion sessions were followed – even remotely – by the main Russian and foreign endovascular surgeons, but also neurosurgeons, vascular surgeons and cardiologists, including Dr. Bernhard Reimers, Director of the Clinical and Invasive Cardiology Unit of Humanitas.
The relation presented by Dr. Reimers
For the occasion, Dr. Reimers presented his study on the similarities and differences in the treatment of acute myocardial infarction and ischaemic stroke, two diseases caused by a blood clot that blocks either the arteries of the heart, causing a heart attack, or those of the brain, causing a stroke instead.
“Both are treated with endo-vascular techniques,” explained Reimers: “i.e. a puncture of a peripheral artery is performed and it is ‘navigated’ with catheters until the occlusion of the vessel which is followed by the opening of the arteries. It is a minivasive procedure: studies have clearly shown that the benefit for the patient in terms of damage to the heart muscle or nerve cells of the brain is enormous. It has also been shown that this acute treatment reduces the mortality and disability of patients with heart attacks or strokes.
Stroke and heart attack: differences in treatment
To date, while endo-vascular treatment is widely used for the heart and heart attack – it is performed in 90% of patients – there is a different percentage of minivasive endo-vascular treatment with regard to stroke, which in Europe and Italy affects only 10% of cases with indications.
“There is a serious delay in the treatment of stroke compared to heart attack,” noted the doctor. “It is important to underline the similarities between the endo-vascular treatment of myocardial infarction and that of cerebral stroke, and this is exactly what I illustrated in my intervention. The aim is to increase and spread these treatments also for stroke”.
“In Russia the approach to these diseases is very interesting because the treatment is not linked to the presence of a cardiologist or a neuroradiologist, but to the work of a ‘vascular interventionalist’. A multidisciplinary approach that overcomes the possible competition or friction between the various specialties”.
The advantages of endo-vascular treatments in stroke
The cases of mortality due to heart attack are certainly lower than stroke, thanks to treatments, and one of the positive things – as explained by the professor is “not only that you survive more but you also return to having an almost normal life, while stroke is still one of the main causes of disability acquired in Western countries. “The goal is precisely to reduce post-stroke brain disability,” concluded Reimers.
The report by Dr. Reimers was prepared with the help of the group of interventionist neuroradiologists of Dr. Paolo Nuzzi, who at Humanitas guarantee the endo-vascular treatment of stroke 24 hours a day.