Endovascular management of acute ischaemic stroke in Nepal

Phuyal, Subash; Poudel, Rajesh; Shrestha, Gentle Sunder; Dawadi, Kapil; Rauniyar, Vivek K; Thapa, Lekhjung; Adhikari, Rupendra Bahadur; Thapa, Amit; Sedain, Gopal; Acharya, Subhash Prasad; Jalan, Pankaj; Pandey, Chakra Raj

doi:10.1016/s2214-109x(20)30071-1

Cited by 6 publications

(4 citation statements)

References 6 publications

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“… 30 Indonesia and Nepal have also recognized the value of telestroke care, especially considering the difficult terrain in these regions. 31 , 32 …”

Section: Stroke Systems Of Care and Challenges To Stroke Services In ...mentioning

confidence: 99%

Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

Sebastian,

Gandhi,

Sylaja

et al. 2023

The Lancet Regional Health - Southeast Asia

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“… 30 Indonesia and Nepal have also recognized the value of telestroke care, especially considering the difficult terrain in these regions. 31 , 32 …”

Section: Stroke Systems Of Care and Challenges To Stroke Services In ...mentioning

confidence: 99%

Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

Sebastian,

Gandhi,

Sylaja

et al. 2023

The Lancet Regional Health - Southeast Asia

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“…With the initiation of endovascular MT in 2019, it has been a standard treatment for acute ischemic stroke recently in few hospitals mostly centered in the capital city Kathmandu. 7 However, there N eurointerventional surgery, also referred to as endovascular neurosurgery or interventional neuroradiology, is a rapidly evolving subspecialty intersected by neurosurgery, radiology and neurology fields. With the introduction of innovative endovascular devices and techniques, it offers minimally invasive approach to most of the neurovascular disorders.…”

Section: Scope and Challenges In Nepalmentioning

confidence: 99%

Neurointervention in Nepal: scope and challenges

Bohara

2023

Nep J Neurosci

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“…In response to these unmet needs, the Nepal Stroke Project (NSP) was initiated in 2021 with the aim of improving access to acute stroke care in Nepal's provincial tertiary care sector. The project was set up in a healthcare setting where multidisciplinary stroke unit care, intravenous thrombolysis, and endovascular treatment were restricted to private tertiary care centers in Kathmandu ( 7 , 10 , 11 ), and the recanalization rate was far <1% ( 12 ). Globally, LMICs such as Nepal face the challenge of translating evidence-based stroke knowledge into clinical practice, but specific guidelines or recommendations tailored to the needs of these resource-limited health settings are not yet available.…”

Section: Introductionmentioning

confidence: 99%

Implementing stroke care in a lower-middle-income country: results and recommendations based on an implementation study within the Nepal Stroke Project

Tunkl,

Paudel,

Bajaj

et al. 2023

Front. Neurol.

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BackgroundGlobally, the majority of strokes affect people residing in lower- and lower-middle-income countries (LMICs), but translating evidence-based knowledge into clinical practice in regions with limited healthcare resources remains challenging. As an LMIC in South Asia, stroke care has remained a healthcare problem previously unaddressed at a national scale in Nepal. The Nepal Stroke Project (NSP) aims to improve acute stroke care in the tertiary healthcare sector of Nepal. We hereby describe the methods applied and analyze the barriers and facilitators of the NSP after 18 months.MethodsThe NSP follows a four-tier strategy: (1) quality improvement by training healthcare professionals in tertiary care centers; (2) implementation of in-hospital stroke surveillance and quality monitoring system; (3) raising public awareness of strokes; and (4) collaborating with political stakeholders to facilitate public funding for stroke care. We performed a qualitative, iterative analysis of observational data to analyze the output indicators and identify best practices.ResultsBoth offline and online initiatives were undertaken to address quality improvement and public awareness. More than 1,000 healthcare professionals across nine tertiary care hospitals attended 26 stroke-related workshops conducted by Nepalese and international stroke experts. Monthly webinars were organized, and chat groups were made for better networking and cross-institutional case sharing. Social media-based public awareness campaigns reached more than 3 million individuals. Moreover, live events and other mass media campaigns were instituted. For quality monitoring, the Registry of Stroke Care Quality (RES-Q) was introduced. Collaboration with stakeholders (both national and international) has been initiated.DiscussionWe identified six actions that may support the development of tertiary care centers into essential stroke centers in a resource-limited setting. We believe that our experiences will contribute to the body of knowledge on translating evidence into practice in LMICs, although the impact of our results must be verified with process indicators of stroke care.

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Endovascular management of acute ischaemic stroke in Nepal

Cited by 6 publications

References 6 publications

Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities

Neurointervention in Nepal: scope and challenges

Implementing stroke care in a lower-middle-income country: results and recommendations based on an implementation study within the Nepal Stroke Project

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