Clyde Yancy, Northwestern University, Feinberg School of Medicine, USA

Until recently PFO closure by endovascular procedure was not generally recommended. However, recently the results of 2 RTCs (CLOSE and REDUCE) and the long-term follow-up of the RESPECT trial were published. These results will have an impact on the current practice. The question now is not “should we close”? but “who to close”? This will be the scope of this debate.

Moderators:
Robert Hart, Mc Master University, Canada
Clifford Kavinsky, Rush University Medical Center, USA

1st Debater: Brett Cucchiara, University of Pennsylvania, USA
2nd Debater: Richard Smalling, UTHealth and Memorial Hermann Heart and Vascular Institute, USA

Moderators:
James Klaas, Mayo Clinic, USA
Christopher Granger, Duke University School of Medicine, USAWolfram Doehner, ESC Council on Stroke; Interdisciplinary Stroke Research Charite, Germany
James Klaas, Assistant Professor of Neurology, Mayo Clinic, Rochester, USA
Carmelo Graffagnino, Duke University School of Medicine, USA
Hooman Kamel, Weill Cornell Medical Center, USA

Moderators:
Frances Caprio, Northwestern University, USA
Milija Mijajlovic, Neurology Clinic, Clinical Center of SerbiaShadi Yaghi, Brown University, USA
MingMing Ning, Harvard Medical School, USA

It is greatly accepted that patients with Embolic Stroke of Unknown Source (ESUS) should go on long-term cardiac monitoring in order to detect sub-clinical AF. However, it is still unknown what is the burden of AF that is clinically relevant to trigger treatment with anticoagulants. This debate will highlight the various opinions: “small vs. extensive” is the dilemma that will be discussed.

Moderator:
Farzaneh Sorond, Northwestern University, Feinberg School of Medicine, USA

The Burden of AF to trigger treatment
1st Debater: Jeff Healey, McMaster University, Canada
2nd Debater: Rod Passman, Northwestern Memorial Hospital, USA

Chairs:
Jeffrey Saver, Geffen School of Medicine at UCLA, USA
TBCRobert Hart, McMaster University, Canada

Cognitive impairment due to vascular pathology of the brain- Vascular Cognitive Impairment (VCI) is an important issue. Understanding the underlying and the related risk factors of VCI as well as the effect of the heart on VCI may have an impact on prevention and treatment of this condition. This symposium will discuss this issue from various aspects.

Chairs:
Philip Gorelick, Thorek Memorial Hospital, USA
Georgios Tsivgoulis, University of Athens, Greece

The Neurovascular Unit and Cognitive Impairment
Constantino Iadecola, Feil Family Brain and Mind Research Institute, USA
Hypertension, Small Vessel Disease and Cognition
Ralph Sacco, Miller School of Medicine, University of Miami, USA
Defining Optimal Brain Health in Adults
Philip Gorelick, Mercy Health Hauenstein Neuroscience Center, USA
Aortic Stenosis, TAVR and Cognition: Imaging and Clinical Findings
Ronald Lazar, University of Alabama at Birmingham, USA
Panel Discussion

Stroke due to ESUS imposes difficult clinical dilemma for the treating physician. The magnitude of the problem, practical evaluation and treatment options will be discussed in this symposium.

Chairs:
Ralph Sacco, Miller School of Medicine, University of Miami, USA
Rod Passman, Northwestern Memorial Hospital, USA

The Magnitude of the Problem
Georgios Tsivgoulis, University of Athens School of Medicine/The University of Tennessee Health Science Center, Greece/USA
Evaluation of Patients with ESUS
Jeffrey Saver, Geffen School of Medicine at UCLA, USA
Treatment options
Gustavo Saposnik, University of Toronto, Canada
Panel Discussion

Chair:
Natan Bornstein, Shaare Zedek Medical Center, Israel
Medical Therapy for Post-Stroke Motor Recovery
Natan Bornstein, Shaare Zedek Medical Center, Jerusalem, Israel
Intracardiac Hemostasis Parameters, Endothelial Damage and Their Association with Microembolization in the Fibrillating Atrium
Laszlo Csiba,University Debrecen, Hungary
Neuroprotection in the Reperfusion Era
Jeffrey Saver, Geffen School of Medicine at UCLA, USA

There are several practical aspects in the treatment of AF patients with AC. This session will deal with three of these important topics as listed below.

Chair:
Jose Biller, Loyola University Medical Center, USA
TBC

How to Improve the Use of Anticoagulation for Stroke Prevention in AF
Christopher Granger, Duke University School of Medicine, USA
When to Start Anticoagulation after Acute Ischemic Stroke
Natan Bornstein, Shaare Zedek Medical Center, Jerusalem, Israel
Treatment of Acute Stroke in AF Patients with Mechanical Thrombectomy
Gregory Albers, Stanford Stroke Center, USA
Panel Discussion

Chairs:
Gregory Albers, Stanford Stroke Center, USA
Wolfram Doehner, Berlin Center for Regenerative Therapies (BCRT), Germany
Robert Hart, McMaster University, Canada

Moderator:
Laszlo Csiba, University Debrecen, Hungary
TBCKevin Sheth, Yale School of Medicine, USA
Eitan Auriel, Carmel Medical Center, Israel

Anticoagulants (AC) are the treatment of choice for stroke prevention in AF patients. However, AC carries a risk of bleeding and especially of Intra-Cerebral Hemorrhage (ICH). Therefore, stroke prevention, acute stroke treatment of AF patients with Mechanical Thrombectomy and when to resume AC after ICH is of a major concern for the treating physician. This symposium will try to clarify these complex and problematic issues.

Chairs:
Mahmut Edip Gurol, Massachusetts General Hospital Harvard Medical School, USA
James Conners, Rush University Medical Center, USA

Stroke Prevention in AF patients at High ICH Risk – Definition and Problems with Medical Management
Edip Gurol, Harvard Medical School, USA
Reversal Agents
John Eikelboom, McMaster University, Canada
Perils of Combination Anticoagulant and Antiplatelet Therapy
Edip Gurol, Harvard Medical School, USA
Resuming Anticoagulation after ICH
Larry Goldstein, University of Kentucky, USA

Panel Discussion