Fana Alemseged (Australia)

Royal Melbourne Hospital, University of Melbourne Neurology
Career summary: Post-doctoral Research Fellow, Level B, University of Melbourne (February 2021), PhD University of Melbourne (February 2021), Neurologist (2017), MD (2011). Dr Alemseged is a stroke neurologist and one of the world’s few experts (and major expert in Australia) in the field of basilar artery occlusion. During her PhD, she has designed and implemented the international, multisite, prospective BATMAN registry for patients with basilar artery occlusion. This globally unique large-scale registry is necessary to study basilar artery stroke due to its rarity and poor natural history, hence the importance of studying the condition to advance treatments. The BATMAN collaboration involves recruiting sites in Australia, New Zealand, Europe and the USA and aims to answer clinical questions regarding this devastating and under-researched form of stroke. Dr Alemseged has published internationally competitive articles on this topic in major journals and presented at >15 key international and national conferences. She has been awarded an American Heart Association junior investigator travel grant award, the Bernard J. Tyson Career Development Award 2020 at the International Stroke Conference and the Stephen Davis Award for Outstanding Fellow of the Year 2020 at the Royal Melbourne Hospital. Dr Alemseged collaborates nationally and internationally with other clinician scientists in the field of stroke. She has contributed to recruitment to major Australian high-impact trials (EXTEND, EXTEND-IA TNK) and other international trials (ESCAPE NA-1, NAVIGATE-ESUS) published in the world’s leading journals. She regularly serves as a reviewer for international journals including Neurology, International Journal of Stroke, Frontiers in Neurology and Journal of Stroke and Cerebrovascular Disease.

Author Of 1 Presentation

 Conference Calendar
Scientific Session: MT (Main Topics)

THROMBOLYSIS AND THROMBECTOMY (IN THE ANTERIOR AND POSTERIOR CIRCULATION)

Session Type
Scientific Session: MT (Main Topics)
Session Name
910 - ACUTE TREATMENT OF ISCHEMIC STROKE (WFN/WORLD STROKE ORGANIZATION JOINT SESSION) (ID 105)
Date
05.10.2021, Tuesday
Session Time
11:30 - 13:00
Room
Main Topic A
Lecture Time
11:30 - 11:53
Presenter
  • Fana Alemseged (Australia)

Abstract

Abstract Body

For nearly two decades, intravenous tissue plasminogen activator (tPA or alteplase) administered within 4.5 hours was the only treatment for acute ischemic stroke. This talk will review current standards of treatment for anterior and posterior circulation acute ischemic stroke.

Recent clinical trials have shown that alteplase given in extended time window or to wake-up stroke patients with favourable CT or MRI-perfusion profile, leads to improved functional outcomes. Although patients with posterior circulation stroke were excluded from these trials, several observational studies demonstrated comparable efficacy and safety profiles of alteplase within 4.5 hours and in extended time window, with few studies suggesting a lower risk of hemorrhagic complications in these patients.

However, alteplase only results in effective reperfusion in 20-30% of patients with anterior circulation large vessel occlusion (LVO) strokes and ~4% of patients with basilar artery occlusion (BAO). Tenecteplase, a genetically modified variant of alteplase with greater fibrin specificity and longer half-life than alteplase, is the most promising alternative thrombolytic agent.

A more effective treatment for LVO is retrieving the clot mechanically with a procedure called mechanical thrombectomy. Several clinical trials demonstrated that mechanical thrombectomy for anterior circulation LVO stroke doubled the odds of disability-free survival compared to alteplase alone. Although recent trials comparing mechanical thrombectomy to standard medical therapy in BAO were underpowered and influenced by equipoise issues, the benefit of mechanical thrombectomy was demonstrated in patients with moderate-severe clinical syndromes (NIHSS≥10). This suggested that thrombolysis might be the optimal treatment in those with milder deficits.

Hide

Presenter of 1 Presentation

 Conference Calendar
Scientific Session: MT (Main Topics)

THROMBOLYSIS AND THROMBECTOMY (IN THE ANTERIOR AND POSTERIOR CIRCULATION)

Session Type
Scientific Session: MT (Main Topics)
Session Name
910 - ACUTE TREATMENT OF ISCHEMIC STROKE (WFN/WORLD STROKE ORGANIZATION JOINT SESSION) (ID 105)
Date
05.10.2021, Tuesday
Session Time
11:30 - 13:00
Room
Main Topic A
Lecture Time
11:30 - 11:53
Presenter
  • Fana Alemseged (Australia)

Abstract

Abstract Body

For nearly two decades, intravenous tissue plasminogen activator (tPA or alteplase) administered within 4.5 hours was the only treatment for acute ischemic stroke. This talk will review current standards of treatment for anterior and posterior circulation acute ischemic stroke.

Recent clinical trials have shown that alteplase given in extended time window or to wake-up stroke patients with favourable CT or MRI-perfusion profile, leads to improved functional outcomes. Although patients with posterior circulation stroke were excluded from these trials, several observational studies demonstrated comparable efficacy and safety profiles of alteplase within 4.5 hours and in extended time window, with few studies suggesting a lower risk of hemorrhagic complications in these patients.

However, alteplase only results in effective reperfusion in 20-30% of patients with anterior circulation large vessel occlusion (LVO) strokes and ~4% of patients with basilar artery occlusion (BAO). Tenecteplase, a genetically modified variant of alteplase with greater fibrin specificity and longer half-life than alteplase, is the most promising alternative thrombolytic agent.

A more effective treatment for LVO is retrieving the clot mechanically with a procedure called mechanical thrombectomy. Several clinical trials demonstrated that mechanical thrombectomy for anterior circulation LVO stroke doubled the odds of disability-free survival compared to alteplase alone. Although recent trials comparing mechanical thrombectomy to standard medical therapy in BAO were underpowered and influenced by equipoise issues, the benefit of mechanical thrombectomy was demonstrated in patients with moderate-severe clinical syndromes (NIHSS≥10). This suggested that thrombolysis might be the optimal treatment in those with milder deficits.

Hide