2023 American Academy of Neurology Abstract Website

Ryna Then¹, Gillian Gordon-Perue², Francene Gayle³, Herbert Manosalva⁴, Cosme G. Villamán⁵, Luis Suazo⁶, Romnensh De Souza⁷, Madihah Hepburn⁸, Santiago Ortega-Gutierrez⁹, Sheila Martins¹⁰, Dileep Yavagal¹¹, Violiza Inoa¹²
¹Cooper Medical School of Rowan University, ²University of Miami, ³King Edward Memorial Hospital, ⁴University of Alberta, ⁵Clínica Corominas y Corazones del Cibao, ⁶Centro de Medicina Avanzada y Telemedicina, ⁷Health City Cayman Islands, ⁸Summa Health, ⁹University of Iowa, ¹⁰Universidade Federal do Rio Grande do Sul, ¹¹University of Miami Miller School of Medicine, ¹²University of Tennessee Health Science Center. Semmes-Murphey Clinic

Objective:

We describe a pathway to facilitate and establish sustainable stroke systems of care including creating stroke-certified centers across the Caribbean region.

Background:

Stroke is the leading cause of neurological related disability and death in the Caribbean. Intravenous thrombolysis and mechanical thrombectomy (MT) are scarce to non-existing in our region with only one certified stroke center in a region of approximately 60 million inhabitants.

Design/Methods:

We connected with regional Stroke experts and created a dyad model of leadership, under the auspices of MT2020+ initiative. The Caribbean Overseeing Committee included eight experienced stroke specialists, who served as an expert panel, coordinated regional solutions based on local public health initiatives and liaised with local country specific physician’s leaders. Committee members interacted regularly with local leadership, established customized collaborations, and built partnerships with specialized local societies, international stroke organizations, Ministries of Health, key stakeholders, and industry. Hands on MT skill workshops were conducted in English and Spanish. The Overseeing Committee facilitated the stroke center certification pathway by the World Stroke Organization (WSO).

Results:

113 physicians from 15 countries participated in the Regional Committees. Train the Trainers workshop in English and Spanish had 85 attendants. The Angels Initiative provided online education; four hospitals became ‘Angels Hospitals’ for the certification pathway. A preferential rate of identification of large vessel occlusion technology (RAPID AI) was obtained for the region, and MT workshops were delivered to 22 neurointerventionalists, 20 nurses and 15 technicians. WSO collaboration facilitated the certification of the first stroke center in the region, located in the Dominican Republic.

Conclusions:

We report the creation of the first ever WSO stroke center certified in the Caribbean Region with 3 other centers on the pathway of certification. These strategies, along with the commitment of local leadership, accelerated the development of stroke systems of care in our region.