By Răzvan Alexandru Radu, Resident Neurologist, University Emergency Hospital Bucharest, Romania

10-23 June, 2019
ESO Department to Department Visit Programme 2019
Host Institution: Stroke Unit, University Hospital Vall d’Hebron Barcelona

First of all I would like to thank ESO and Dr. Marta Rubiera for giving me the opportunity to visit the Stroke Unit of the University Hospital Vall d’Hebron in Barcelona.

Vall d’Hebron Hospital is a pioneering and leading institution in the field of cerebrovascular disease. During my visit, I found out that some 10 years ago Dr. Marc Ribo was the first to establish a tele-stroke line in Catalunya. The aforementioned line, is still in use today but it is now part of the complex and state-of-art system of stroke care that constantly innovates and reinvents itself, in order to deliver the best possible stroke care to the people of Catalunya.

During my visit I was cordially invited by Marta Rubiera to attend a workshop that presented their current achievements and future goals in terms of organizing the delivery of stroke care in Catalunya. Being able to learn directly from Dr. Carlos Molina, Dr. Marc Ribo, Dr. Marta Rubiera how they went from one tele-stroke line to an interconnected system that aims to treat 1000 patients with thrombectomy a year with excellent door-to-needle and door-to-groin times was a priceless experience for someone coming from a country where acute stroke care is just taking his first steps.

I was enthralled by the efficiency of stroke codes in Vall d’Hebron. Besides the fact that they enroll patients in the already well known RACECAT trial they are also randomizing patients to go directly to the angio-suite. In this way I was able to observe seemingly impossible (short) door-to-groin times which were further complemented by skillful thrombectomies performed as everything else in Vall d’Hebron also by a Neurologist who dedicated his time and trained for this.

During my visit, I also had the opportunity to observe and be involved in the daily routine of the stroke unit. Observing the organization of the stroke unit has prompted many ideas about how to improve things at home.

A remarkable fact about stroke care organization in Vall d’Hebron is that stroke neurologists, in particular Dr. Jorge Pagola and Dr. Jesus Juega, also perform echocardiography and select patients for extended heart rhythm monitoring. During several and insightful discussions with them, I came to understand the value of having a vascular neurologist performing the cardiologic focused work-up of stroke patients.  With increasing burden of stroke world-wide it will be probably a need for the future vascular neurologists to achieve skills for focused cardiologic evaluation of stroke patients – and I am sure that the experience developed in Vall d’Hebron will play a major role in establishing specific protocols and criteria.

All in all the experience in Vall d’Hebron was enriching not only just for developing a comprehensive overview of stroke care system organization but also in motivating me to pursue my personal aspirations. This is why I would like to thank again to all the staff of the Vall d’Hebron Hospital for the warm and friendly time spent with them during my visit.

Considering planning your own visit?

The deadline to apply for the ESO 2020 Department to Department Visit Programme is 28 February 2020.