Stroke patients in Korea and Japan share some similarities, such as high percentages of small vessel disease, intracranial atherosclerosis, and moyamoya disease, and dietary and lifestyle habits are also comparable. The care system in Korea and Japan are also similar and both countries favor the use of cilostazol for secondary stroke prevention [1,2]. Thus, it was natural that the core members of the Korean and Japan Stroke Societies (KSS, JSS) proposed the idea of holding regular stroke conferences together. Prof. Jae-Kyu Roh and Prof. Kwang Ho Lee from the KSS and Prof. Yukito Shinohara from the JSS first initiated the idea and pioneered the first joint conference.

At the organizers’ meeting of the 9th KJJSC in November 2019, it was determined that the 10th KJJSC in 2021 would be held on-site in Osaka. There was no doubt about the feasibility of an in-person conference at that time. However, when the coronavirus disease 2019 (COVID-19) pandemic swept across the globe, our original plan had to change drastically. We conducted the first-ever virtual KJJSC conference from a small studio in Namba, Osaka, on September 17 (Saturday) and September 18 (Sunday) in 2022.

The theme of KJJSC 2022 in Osaka was “New friendship between K & J in the new standard era.” At this conference, six official symposiums were set, and the current conditions of Korea and Japan were compared. For example, four complete or ongoing trials were introduced. The Korean investigators presented the “Outcome in Patients Treated with Intraarterial thrombectomy: optiMAL Blood Pressure control (OPTIMAL-BP)” trial [3] and the “Dual antiplatelet Use for extended period taRgeted to AcuTe Ischemic stroke with presumed atherosclerotic OrigiN (DURATION)” study, while the Japanese researchers discussed the “Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism Japan - Large IscheMIc core Trial (RESCUE-Japan LIMIT)” trial [4] and the “STroke secondary prevention with catheter ABLation and EDoxaban for patients with non-valvular atrial fibrillation (STABLED)” study [5]. In addition, presentations on machine learning for stroke subtype classification [6] and digital stroke therapies [7] were delivered by Korean speakers, and ring finger protein 213 (RNF213)-related arteriopathy [8] and multi-lineage differentiating stress enduring (Muse) cell therapy [9] were presented by Japanese speakers. Other interesting presentations included “Mechanical thrombectomy and the acute stroke care system,” “Cerebral small vessel disease and cognitive/psychiatric disorders,” “New pharmacotherapy for stroke (such as tenecteplase, nerinetide, factor XIa inhibitors, and prasugrel for stroke),” and “The social approach to stroke (health policy and academic support).” Moreover, the nine sponsored symposiums focused on implantable loop recorders for occult atrial fibrillation (AF), AF-related dementia, direct oral anticoagulants and their antidotes, angiotensin receptor-neprilysin inhibitors, patent foramen ovale closure, and acute mechanical thrombectomy.

Currently, the World Stroke Organization (WSO) Brain & Heart Task Force developed the “Brain & hEart globAl iniTiative (BEAT)” a pilot feasibility program aimed at establishing clinical collaborations between cardiologists and stroke physicians working at large healthcare facilities. In the Joint WSO, KSS, and JSS Symposium, the current brain-heart relationship activities in Korea and Japan were presented after the keynote speaker, Prof. Luciano A Sposato, from Canada, introduced the WSO-BEAT [10]. In another Joint Symposium of the Asia-Pacific Stroke Organization, KSS, and JSS, stroke care in Korea and Japan during COVID-19 was compared after the keynote presentation by Prof. Narayanaswamy Venketasubramanaian Ramani, from Singapore [11].

In total, 278 delegates participated in the 10th KJJSC, including 236 paid attendees and invited attendees from Korea, Japan, Taiwan, Thailand, Indonesia, Malaysia, Australia, Canada, and Singapore. There were 129 abstracts. All abstracts are available from the Journal of Stroke’s home page, under “Browse Articles” (https://www.j-stroke.org/articles/abstract_book.php). Although we could not provide “omotenashi” in Osaka, the quality of our speakers and their presentations was high.

The 11th KJJSC will be held in Busan in November 2023. We hope that the 11th KJJSC will be an in-person conference. Hopefully, the 10th KJJSC was the first and the last virtual conference.