ESO East Supplement 2023 - 28

1108739
article2022
ESO0010.1177/23969873221108739European Stroke JournalYeghiazaryan et al.
ESO EAST Project Supplement
Stroke care in Armenia: Recent
developments
Nune Yeghiazaryan1,2 , Anna Isahakyan2, Lina Zubalova1,2,
Yekaterina Hovhannisyan3, Greta Sahakyan4, Sharon Chekijian5
,
Samson G Khachatryan2, Mikael Skon Muratoglu6,
Manvel Aghasaryan7 and Viken L Babikian8; on behalf of the Armenia
Stroke Council
Abstract
Introduction: Armenia is an upper-middle-income country with a population of nearly 3 million. Stroke is one of its
major public health problems and ranks as the sixth leading cause of death, with a mortality of 75.5 per 100,000.
Methods and results: Until recently, modern stroke care was not available in Armenia. During the past 8 years
substantial advances have been made in building medical infrastructure and delivering acute stroke care. This manuscript
describes contributors to this progress, including extensive and long-term collaboration with international stroke
experts, the development of hospital-based stroke teams, and a funding commitment for stroke care by the government.
Conclusion: The results of acute stroke revascularization procedures during the past 3 years are reviewed and found
to meet international standards. Future directions are discussed including the immediate need to expand acute stroke
care to underserved parts of the country by adding primary and comprehensive stroke centers. An active educational
program for nurses and physicians and the TeleStroke system development will help support this expansion.
Keywords
Epidemiology, stroke, organization of stroke care, Armenia, thrombolysis, mechanical thrombectomy, stroke
fellowship
Date received: 20 April 2022; accepted: 2 June 2022
European Stroke Journal
2023, Vol. 8(1S) 28 -34
© European Stroke Organisation 2022
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DOI: 10.1177/23969873221108739
journals.sagepub.com/home/eso
https://doi.org/10.1177/23969873221108739
Introduction
Armenia is considered an upper-middle-income country
with a population of nearly 3 million.1 Its population is
aging.1,2 As of 2020, stroke was the sixth leading cause of
death in Armenia, with a mortality of 75.5 per 100,000 population.3
Advances in stroke prevention, therapeutic interventions
for acute stroke, the development of stroke centers,
and national organizations advocating for stroke care have
lowered stroke incidence, morbidity, and mortality in highincome
countries.4 During the last four decades, while
stroke incidence declined by 50% in high-income countries,
it doubled in low- and middle-income countries,
including Armenia.5 Until recently, modern stroke therapies
such as thrombolysis and mechanical thrombectomy were
not available in Armenia. The existing stroke care was not
organized as a national network. Significant steps have
been taken in stroke care during the last 8 years to reflect
state-of-the-art evidence-based practices. Their greatest
impact has been on acute stroke treatment. Public education
and primary and secondary prevention of stroke remain
major challenges to be addressed. In this manuscript, we
present the epidemiological data pertinent to stroke and
1 Neurology Department & Stroke Unit, Erebouni Medical Center,
Yerevan, Armenia
2 Neurology and Neurosurgery Department, Armenian National Institute
of Health, Yerevan, Armenia
3 Neurology Department & Stroke Unit, Yerevan State Medical
University Hospital, Yerevan, Armenia
4 Neurology Department & Stroke Unit, Astghik Medical Center,
Yerevan, Armenia
5 Department of Emergency Medicine, Yale School of Medicine, New
Haven, USA
6 Division of Neurology, University of Alberta, Edmonton, AB, Canada
7 Stroke Unit and Neurology Department, Sud Francilien Hospital,
Corbeil-Essonnes, Paris Region, France
8 Department of Neurology, Boston University School of Medicine,
Boston, MA, USA
Corresponding author:
Nune Yeghiazaryan, Neurology Department & Stroke Unit, Erebouni
Medical Center, 14 Titogradyan Street, Yerevan 0087, Armenia.
Email: ynune@yahoo.com
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