This session will be available for virtual attendees within 24 hours after concluding in New Orleans.

Globally, there are 13.7 million strokes per year and one in four people over the age of 25 will have a stroke in their lifetime. This burden of stroke is borne disproportionately by low and middle-income countries (LMIC) which account for over 2/3rd of all stroke cases, with strokes occurring 15 years earlier and stroke-related disability and mortality higher than in high-income countries (HIC) .

Recently, the RESILIENT randomized clinical trial showed that there is overwhelming benefit of emergency mechanical thrombectomy (MT) with or without IV tPA done within 8 hours of symptom onset in mitigating disability and mortality related large vessel occlusion stroke (LVOs) compared with medical therapy alone, in the public health system of Brazil, a LMIC. Furthermore cost-effectiveness studies suggest that MT is very likely to be cost-effective in LMICs given the large cost of post-stroke care and lost productivity. However, the availability and hence timely access to MT is limited to scare in LMICs in 2021. Thus there is a critical need to prioritize building of thrombectomy capacity in these regions. Policy makers need to be educated about the major public-health and economic burden posed by LVOs as well as the new highly beneficial and cost-effective first line treatment of MT so that resources and planning can prioritize building of thrombectomy systems in their regions.

This session will discuss the lessons learnt from the RESILIENT trial in implementing MT in the public health system of a LMIC and the overall cost-effectiveness data on MT for LVOs. The session will also discuss the progress achieved with the Mission Thrombectomy 2020+ global campaign roadmap for building thrombectomy capacity in LMICs. Lastly but not least important will be the discussion on continuing to build thrombectomy capacity in LMICs in the face of the COVID-19 pandemic.

Santiago Ortega-Gutierrez MD

UNIVERSITY OF IOWA HOSPITALS

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