Breakthrough advances in stroke treatment

In stroke care, “time is brain,” because for every minute that a cerebral blood vessel remains blocked, approximately 1.9 million nerve cells die.

Assoc. Prof., PhD, MD Nguyen Huy Thang presents the Diamond Certification of the World Stroke Organization to Thong Nhat General Hospital. Photo: Hanh Dung

Assoc. Prof., PhD, MD Nguyen Huy Thang, Vice President of the Vietnam Stroke Association, President of the Ho Chi Minh City Stroke Association, and one of the pioneers in applying thrombolysis and endovascular intervention, ushering in a modern era of stroke treatment in Vietnam, emphasized: The goal of stroke treatment is not only to save patients’ lives, but also to help them recover early and return to everyday life.

Two breakthrough advances in stroke treatment

• Stroke treatment is a field advancing at a very rapid pace. How is this reflected in practice?

– Stroke is one of the fields in which medical knowledge evolves almost every year. While many areas of neurology saw little significant change 30 years ago, stroke treatment has undergone a complete transformation. What was considered “standard” just a few years ago may now be outdated.

For instance, if a book on stroke treatment were written in 2025, many of its recommendations could become obsolete within just one or two years. This rapid pace of change makes continuous knowledge updates a mandatory requirement for medical professionals involved in stroke care.• What are the most notable recent advances in stroke treatment?

– There are two groundbreaking advances. The first is the expansion of the treatment window. Before 2018, the timeframe for administering thrombolysis or performing mechanical thrombectomy was limited to just 4.5 to 6 hours. However, thanks to large-scale studies, the treatment window has been extended to up to 24 hours for certain eligible patient groups. This accomplishment is a breakthrough, offering a treatment opportunity even to patients in severe condition or those who arrive late at the hospital.

Assoc. Prof. PhD MD Nguyen Huy Thang emphasizes: To prevent stroke, risk factors must be brought under control. Hypertension is responsible for about 90 percent of stroke cases. Therefore, blood pressure should be monitored regularly and treated early. In addition, diabetes should be managed; smoking should be avoided; alcohol consumption should be limited; a healthy weight should be maintained; and a healthy lifestyle should be adopted.

For example, at People’s Hospital 115, where I work, before the treatment window was expanded, only about 400–500 interventional procedures were performed each year. After applying the 24-hour window, the number increased to 1,700–1,800 cases per year. That means more than 1,200 additional patients are saved or have severe disabilities reduced thanks to this advance.

The second advance is the nationwide improvement in the quality of stroke treatment centers through internationally standardized training programs, the hub-and-spoke (central–satellite) model, and imaging-support technology systems. These developments enable doctors at provincial-level hospitals, such as in Dong Nai, to rapidly access advanced treatment methods, significantly reducing the need to transfer patients to Ho Chi Minh City.

Expanding the stroke treatment network

• Currently, stroke treatment is still mainly concentrated in major hospitals. How can access be expanded for people in remote and rural areas?
– This is a significant challenge and has been a priority of the Vietnam Stroke Association for many years. We have coordinated with international organizations, such as the Angels Initiative and the World Stroke Organization, to develop a nationwide stroke network.

About 10 years ago, Vietnam had only a handful of stroke centers. Today, that number has grown sevenfold to eightfold, reaching around 150 centers. What’s important is not just the increase in quantity, but also the improvement in quality through training, coaching, and the transfer of medical techniques to provincial hospitals.

At the same time, the “hub-and-spoke” network model is being vigorously implemented. A major stroke center provides professional support to multiple nearby satellite hospitals. These satellite hospitals are responsible for the early detection of stroke and for transferring patients to appropriate centers as quickly as possible.

• How do you assess stroke treatment in Dong Nai?
– Dong Nai is one of the bright spots in stroke treatment nationwide. Among the five hospitals providing stroke care, Dong Nai General Hospital and Thong Nhat General Hospital have achieved Diamond Certification, the highest certification of the World Stroke Organization (nationwide, only about 10 hospitals have attained this level). Long Khanh Regional General Hospital has achieved Platinum Certification. To earn these certifications, hospitals must meet stringent and comprehensive criteria that encompass patient intake processes, response times, interventional capacity, and treatment outcomes.

With a population of more than 4.4 million, Dong Nai has a very high demand for stroke treatment. A widely organized treatment system helps residents avoid long-distance travel, saves “golden time,” preserves brain cells, and reduces treatment costs. The benefits to the community are enormous.

Moreover, Dong Nai has demonstrated a proactive spirit of learning, strong engagement in professional networking, and consistent participation in ongoing training programs, enabling its medical teams to stay current with the latest advancements. This breakthrough is clearly reflected in the professional standards and expertise in acute stroke care at the province’s hospitals.

• Thank you very much, Assoc. Prof., PhD, MD Nguyen Huy Thang!

By Hanh Dung – Translated by Trieu Ngan, Minho