ESO TF4UKR Department-to-Department Visiting Programme

As part of the ESO TF4UKR D2D Visit Programme, I was afforded the opportunity to visit the stroke and neurointerventional department at the Lisbon Central University Hospital (São José Hospital) at a kind invitation of MD PhD Professor Diana de Aguiar Dias de Sousa.

My principal objective was to gain insight into the comprehensive management of acute stroke, from the initial stages through to the patient’s discharge. I also aimed to prepare a young stroke protocol for my hospital as part of my research, and to discuss the difficulties encountered while treating patients with acute ischaemic stroke, with a particular focus on endovascular techniques. I therefore had the opportunity to observe the hyperacute management of stroke (including clinical and neuroimaging assessment, acute treatment with IVTPA and thrombectomy) as well as further investigation into the aetiology of stroke, appropriate treatment and follow-up planning. I also observed the whole range of further diagnostic tests (TCD, TTE, TCD bubble test – which I also learned from doctors and tried to do myself) and all neuroimaging with further discussion with neuroradiologists.

   
I experienced great teamwork, clinical case discussions every morning and also a lot of educational lectures for younger colleagues, which I found very helpful in educating the younger generation.

During my time at the hospital, I observed a number of interesting and unique clinical cases, including some that were particularly rare. Additionally, I had the opportunity to present a rare case of bilateral carotid web from Hospital de São José at the 15th SPAVC Stroke Conference.

Afterwards, my mentor, Diana Aguiar de Sousa, and I worked together on the stroke protocol for young patients, that I would like to implement in my country. We also discussed the differences between our stroke units, some diagnostic gaps in my country and highlighted the main ways to address them in order to build a better stroke care in Ukraine.

Furthermore, while in the neurointerventional department under the guidance of MD, PhD, Associate Professor Isabel Fragata, I had the opportunity to observe several neurointerventional procedures, including those that were particularly noteworthy. These included the treatment of complex AVMs, ICA dissections, various types of cerebral aneurysms, endovascular treatment of CVT, and a substantial number of thrombectomies in acute ischemic stroke.

Due to my profound interest in neurointerventional treatment, I attended a Neurovascular Intensive Interventional Course organised by Isabel Fragata in Lisbon. This granted me the chance to learn from the leading experts in this field.

In conclusion, I would like to express my gratitude to the ESO organization once more for providing me with this invaluable opportunity. I am also grateful to my mentor, Professor Diana de Aguiar Dias de Sousa, for her guidance, kindness, and support. Her assistance was very important in enabling my participation in the clinical case presentation, participation in all clinical ward work, and interdisciplinary discussions, and in developing an essential young stroke protocol for my hospital. Furthermore, she comprehensively answered all my questions related to my clinical stroke practice in Ukraine. I would also like to express my gratitude to MD, PhD, Associate Professor Isabel Fragata, the head of the neurointerventional Department, for allowing me to observe most neurointerventional procedures, address my queries, and participate in the hands-on interventional course.

Sincerely,
Thanks from Ukraine
Marharyta Kholodova, MD