Abstract:

Established by Boehringer Ingelheim in 2015, in collaboration with international stroke experts and the European Stroke Organisation (ESO), the Acute Networks StrivinG for ExceLlence in Stroke (ANGELS) project has had a major impact on expanding available treatment for acute stroke patients and improving outcomes in Europe. The principal objective of ANGELS is to increase the number of acute stroke patients treated in stroke units and to optimize the quality of treatment by providing stroke teams with the tools, training and support they need for hospitals to attain accredited stroke-ready status. The ANGELS initiative also seeks to optimize stroke networks between individual hospitals and countries. ANGELS-led interventions in European countries have resulted in a significant reduction in door-to-needle times (DNTs), and other delays that impede rapid and most appropriate treatment. The ANGELS project has encouraged expansion of European stroke patient registries, use of standardized best-practice treatment protocols, and increased
reporting of outcomes at the level of individual stroke centres.

In many parts of the world, the availability of acute stroke treatments continues to be limited or non-existent. Stroke patient assessments are often not consistent or guideline-compliant, and effective treatments such as thrombolysis and mechanical thrombectomy cannot be accessed. In contrast, in Europe and the USA, acute stroke treatment has moved from an era of no or limited treatments, to the use of some of the most effective treatments and interventions available in medicine. This report summarizes the important progress and some of the measurable successes that are being made through the adoption of the ANGELS initiative in non-European countries. The ANGELS project model, with some appropriate language and local country cultural adaptions, is making significant improvements in the extent and quality of acute stroke treatments. Objective measurable successes include: reduced hospital transfer times, increased i.v. thrombolysis rate, reduced DNT, compilation of stroke registry data, and increased public awareness of the signs and symptoms of acute stroke.

Keywords:

acute stroke, ANGELS initiative, stroke-ready hospitals, thrombolysis