Umbrella, Heart And Stroke / Learning objectives

1st session

2nd session

3rd session


Practical advice on detecting & managing patients with PFO

  • Epidemiology and the PFO-associated illnesses
  • Anatomy and morphology of PFO:
    Pathologic and therapeutic implications
  • Differences between PFO & ASD
  • Diagnostic techniques for:
    • PFO detection
    • Assessing the morphology of PFO
    • Quantification of the right-to-left shunt
  • Decision pathways for optimal PFO management for the secondary prevention of stroke
  • Calculators for risk estimation in patients with stroke & PFO
  • Reviewing randomized trials comparing PF closure with medical therapy
  • Updated indications for PFO closure for the secondary prevention of stroke
  • The work-up of cryptogenic stroke :
    Pre-PFO closure investigations to rule-out other potential causes of stroke
  • Complications of PFO closure
  • Optimal regimen & duration of antithrombotic therapy after PFO closure
  • Role of antithrombotic therapy in patients with PFO and no indication for closure
  • Clinical significance of PFO in other illnesses:
    • Decompression Illness
    • Platypnoea–Orthodeoxia Syndrome
    • Migraine with Aura
  • Identification of a high risk PFO-associated stroke prior to the first stroke
  • Role of prophylactic PFO closure in high-risk patients such as thrombophilia

The role of carotid stenosis management in the primary and secondary prevention of stroke

  • Screening for carotid artery stenosis: indications
  • Diagnostic evaluation of carotid artery stenosis: choosing the best imaging method & decision pathway
  • Ultrasonographic criteria for the severity of carotid artery stenosis
  • Management of asymptomatic carotid stenosis
  • Management of symptomatic carotid stenosis
  • Revascularization: CAS or CEA?
  • Medical Therapy (antithrombotic therapy in primary prevention, optimal lipid and BP control, and Life-style modification)

Atrial fibrillation screening: from risk prediction to detection and clinical outcomes

  • Indications for rhythm monitoring to detect AF after ischemic stroke
  • Optimal duration & method for AF detection in patients with ischemic stroke
  • Duration threshold & burden of AF in extended rhythm monitoring to initiate anticoagulation
  • Definition of cryptogenic stroke & ESUS
  • Indications for anticoagulation in ESUS
  • Indications of systematic AF screening in the community
  • Diagnostic yields of various AF screening methods and across populations subgroups
  • Recommended methods for systematic and opportunistic AF screening
  • Clinical significance of AF rhythms detected in screening methods and therapeutic implications
  • The burden of AF associated with significant stroke risk
  • Clinical significance and management of AHRE in rhythm monitoring
  • The best approach to AF screening in asymptomatic patients

Antithrombotic therapy for secondary prevention of stroke

  • Early Antithrombotic treatment in TIA/CVA (First days)
    • Anti-platelet therapy: agents of choice
    • Anti-coagulant therapy: choosing the agent and the duration of use
  • Chronic Antithrombotic therapy (including ESUS)
    • Indications for DAPT
    • Choosing between P2Y12 inhibitors and the duration of therapy
    • Extended DAPT duration: indication & the combination of choice
    • Choosing the best Monotherapy strategy
    • Indications for DPI
  • CVA/TIA in patient with Atrial Fibrillation
    • Antithrombotic therapy after CVA/TIA
      • choosing between oral anticoagulants (VKA/NOACs)
      • Indication for antiplatelet therapy
  • Antithrombotic therapy after PCI in patients with a history of embolic stroke
    • Oral anticoagulant and antiplatelet of choice: optimal duration
  • Choosing the antithrombotic therapy in special situations:
    • After carotid revascularization: CAS/CEA
    • Antiplatelet therapy failure
    • Cerebral and cervical artery dissection