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UMHAT „St.Marina”-Varna – awarded with a prize by the european stroke organization

UMHAT "St. Marina" - Varna has received a new excellent evaluation for high quality in the treatment of patients with stroke by the President of the European Stroke Organization - Prof. Valeria Caso, at a national meeting, organized by the Bulgarian Society of Neurology. The forum was held on 27th January 2018 in Sofia, under the slogan: "Together along the way of change. Let's give life a chance". The meeting was opened by Prof. Valeria Caso, President of the European Stroke Organization (ESO). In her introductory lecture Prof. Caso focused the attention on modern therapeutic approaches in treatment of acute ischemic stroke, as well as on the importance of collaboration between the organizations to ensure optimal outcomes of patient care.

Since 2015 Bulgaria has joined ESO EAST Project, and since 2016 - the ANGELS Project, whose ultimate goal is to establish an international community of hospitals for treatment of stroke, targeted at improving the quality. Second Neurology Clinic with a Department for Treatment of Acute Stroke at UMHAT "St. Marina" - Varna is the first centre in the country that introduced quality indicators in everyday clinical practice in patients with acute stroke as early as 2015. It is the first centre registered in ANGELS Programme - Bulgaria. The participation in RES-Q - Registry of Stroke care quality contributes to the optimization of the therapeutic approach in the Clinic. The prize, awarded personally by the ESO President Prof. Caso, is high recognition for the achieved high quality in the treatment of stroke patients at UMHAT "St. Marina".

The new consensus on modern therapeutic strategies in the treatment of cerebrovascular diseases in Bulgaria was presented at the meeting as well. As a representative of the Department of Neurology and Neuroscience at Medical University - Varna, Prof. Ara Kaprelyan took part in its writing. The head of Second Neurology Clinic Prof. Silva Andonova participated in the discussion not only as a representative of the biggest Centre for Treatment of Stroke in Northeastern Bulgaria, but also as a National Consultant in Interventional Neurology. She welcomed the initiative of the Bulgarian Society of Neurology, related to the presentation of a new consensus, and further on she emphasized on the fact that the consensus united the efforts of different societies, including the current consensus on mechanical thrombectomy, adopted at the end of 2016, which she had co-authored as well. Prof. Andonova put the stress on the need to establish a national network of centres for stroke treatment. She reminded the audience that there were all the normative documents, defining the requirements for the differentiation of different stroke centers - the current Standard on Neurology Diseases defines the requirements to be met by the Department of Stroke Treatment and pursuant to an Order by the Minister of Health, dated 28.06.2016 - the requirements for the establishment of a high-tech cerebrovascular centre, in which endovascular treatment of patients with acute stroke can be performed. She proposed a network of centres to be built by regions, and in each region the University Hospital to play a leading role in uniting the other centres for stroke treatment in the region. Prof. Andonova also addressed the issue of training healthcare professionals and the proposed discussion by the Society for establishment of highly specialized activities (HSA) for interventional specialists, performing endovascular treatment. Only medical universities have the capacity and the capabilities to carry out this kind of training. Regarding the discussion on the elaboration and introduction of highly specialized activities, we can underline once again the leading position of Medical University - Varna, because through a Decision of the Academic Council from August 2016, two separate highly specialized activities were established "Differentiated treatment of patients with acute ischemic stroke - basic level" and "Differential treatment of patients with acute ischemic stroke - intervention therapy",  with relevant training programmes, through which not only interventional specialists but also multidisciplinary teams, involved in the appropriate treatment, have the opportunity to gain knowledge and experience.

At the end of the meeting the experience of thrombolytic treatment, accumulated over the years by five centres was presented - UMHAT "St. Anna" - Sofia as a centre that has shown very good development over the two-year period, in which it has performed thrombolytic treatment; MHAT "St. Panteleimon" - Plovdiv - as a centre, where intravenous thrombolysis was performed for the first time in Bulgaria in 2005; UMHAT - Pleven; and three district  hospitals from Northeastern Bulgaria - Shumen, Targovishte and Silistra. The head of the Neurology Department - Shumen pointed out the important role of a part of the team at the Second Neurology Clinic at University Hospital "St. Marina" in the introduction of intravenous thrombolysis in the treatment of acute ischemic stroke in the region more than eight years ago.

The second national meeting dedicated to the ANGELS Programme in Bulgaria, was closed by Prof. Caso, reminding once again the opportunities, provided by the programme for supporting specialists directly involved in the treatment of acute stroke by providing algorithms, training films, etc.