Background Advances in stroke care like most innovations in medicine have happened gradually, over time, in increments and have typically benefitted from the collaborative efforts of a diverse group with a common goal. The CLOT summit inaugurated in 2015 created an ecosystem guided by these principles to evaluate and develop pathways for enhancing stroke care.
Methodology Three core groups are invited to participate. These include scientists involved in clot research, engineers involved in device development and physicians involved in interventional and medical treatment of acute ischemic stroke. The initial format followed a focused group discussion and presentation on key topics leading to development of targeted projects. In subsequent years the outcome from previous year’s summit was evaluated and a future course in basic and clinical research charted. A key clinical component was improving procedural performance and defining unmet needs.
Results To date, the output has covered several areas. Basic clot research: ex vivo clot analysis resulted in five registries in the US (one) and the EU (four) with the aim of multicenter collection of thrombectomy specimen with centralized analysis. This has yielded several publications in the JNIS and elsewhere. Procedure optimization: Pre-intervention imaging analysis involved multiple contributions on thrombus imaging using CT/CTA/MR. In-Vitro modeling for thrombectomy procedures centered around procedural aspects (tortuosity, the effects of flow and pressure, embolization to new territory) and clot interaction (fibrinous or calcified clots versus friable clots). Progress in device iteration was part of procedure optimization based on in-vitro modeling and review of challenging cases highlighting a potential unmet solution. Clinical Studies: These were a product of the first two and involve clinical studies related to new devices and clinical registry for calcified clots.
Conclusion The CLOT summit represents a novel incubator platform bringing together expertise in a coordinated fashion that has resulted in meaningful basic and clinical contribution to the evolving stroke care. Key outcomes of the summit over the first 5-years are presented.
Disclosures A. Rai: 2; C; Cerenovus, Microvention, Stryker Neurovascular. J. Fiehler: 2; C; Cerenovus. R. McCarthy: None. A. Siddiqui: 2; C; Cerenovus. D. Liebeskind: 2; C; Cerenovus. W. Hacke: 2; C; Cerenovus.
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