Optimizing Reperfusion Trials: A Consensus Research Roadmap From the STAIR XIII Conference

Area of Science:

• Neurology
• Cardiovascular Research
• Medical Imaging

Background:

• The Stroke Treatment Academy Industry Roundtable (STAIR) convened experts to address challenges in acute stroke reperfusion therapies.
• Recent advancements in intravenous thrombolytics and endovascular thrombectomy have expanded treatment options for acute stroke.

Purpose of the Study:

• To develop consensus recommendations for research priorities and trial design in stroke reperfusion therapies.
• To identify strategies for overcoming logistical challenges in conducting trials at primary stroke centers.

Main Methods:

• A workshop was held during the STAIR XIII conference, gathering stroke specialists, researchers, and industry representatives.
• Discussions focused on summarizing recent acute stroke trials, defining research priorities, and exploring trial design elements.

Main Results:

• Consensus was reached on key research priorities and trial design challenges for reperfusion therapies.
• Establishing research networks to facilitate trials in the transfer setting, particularly at primary stroke centers, was identified as crucial.
• The importance of defining and investigating microvascular reperfusion and the no-reflow phenomenon was emphasized.

Conclusions:

• Future stroke reperfusion trials require enhanced research networks and improved imaging research.
• Addressing the challenges of patient recruitment at primary and comprehensive stroke centers is essential for advancing novel thrombolytic therapies.
• Clearer definitions and investigations into microvascular reperfusion are needed to improve patient outcomes.