The Rule of Three

The Rule of Three

Dr Sandor Nardai is a cerebrovascular disease specialist and chief of the biggest thrombectomy centre in Hungary. As a licensed interventional cardiologist, neurologist and neurointerventionist, he is making an outsized contribution to stroke care in his country.   During a conversation recorded in Maastricht in May 2026, Sandor explained the “triple rule” that governs his career:   “From the very first part of my career, I really wanted to do the three jobs you need to do at the university clinic. So teaching, research, and healing patients. First was research. But then medicine really was interesting, and I thought that, well, if I do a medical degree, I could still be a researcher. And education is just fully integrated into it because it's a medical school.”  Sandor is associate professor and the head of Department of Neurointervention at the Semmelweis University Center of Neurosurgery and Neurointervention in Budapest, Hungary.   It’s a great job to be in, he says.    In this episode:   * Committing to the triple task of research, teaching and healing  * What cardiologists and neurologists can learn from each other  * Learning together on the job  * The importance of going abroad  * Why stroke is fascinating  * Why interventionists have to be team players  * Important questions research must answer  * Studying for an MBA  * A day in his life  * Leaving a legacy  Find out more about the Angels Initiative: www.angels-initiative.com

In the right place at the right time

In a conversation recorded in Maastricht during ESOC 2026, Latvian neurologist Kristaps Jurjāns explains how consistency earned Pauls Stradins Clinical University Hospital in Riga more diamond awards than any other hospital in the world.   He says, “Mostly what gives us these awards is that we do it consistently. We do not drop our standards and our data shows this. I can trust everybody that works in our hospital with the stroke patients to provide acute care at the highest level.”  He describes missing the cut to become an orthopedic surgeon, following his mom into neurology, just temporarily, and then forgetting all about surgery as he learned about stroke neurology from his mentor Professor Evija Miglāne.   It’s “inevitability” that drives him, he says. “If I drop this, who's gonna pick it up? That’s the first question. And the next question is, so if somebody does, am I happy about it? If not, then you have to do it yourself.  Finally, Kristaps explains how working out with a boxing coach eases the transition from hospital to the  Jurjāns household which is currently occupied by three small boys including two-year-old twins.     In this episode:  * Cycling from Brussels to Maastricht  * Getting an award for getting an award  * Why consistency matters  * “You have to rise or somebody dies”  * Choosing neurology (or not)  * Having doctors in the family  * Raising boys  * Getting in the ring  * “What else should I be doing?”  Find out more about the Angels Initiative: www.angels-initiative.com

All the world’s a stage

In this episode recorded in Maastricht during ESOC 2026, Italian neurologist Professor Danilo Toni reflects on three decades of stroke care transformation in Italy. He describes a flourishing relationship between Angels and the Italian Stroke Association (of which he is a past president), the genius of the data activation program MonitorISA, and the Trojan Horse strategy that paved the way for the proliferation of stroke units in Italy.  He recalls his role in the ECASS trials that fundamentally transformed stroke care, and outlines the most urgent questions that remain unanswered.  A passionate actor who is currently playing King Lear in an offbeat amateur production, he shares his views on the benefits of being on stage:  “Thanks to theater, you can show your emotion without any limitation, without any judgment, not your personal judgment toward yourself, nor the one toward the others ... It’s the best thing I could do for myself. And I always say it is better than any benzodiazepine and any anti-anxiety treatment and antidepressant treatment. And I definitely suggest to everyone should do it.”    In this episode: * First encounter with Angels  * The genius of MonitorISA  * Dramatic changes for stroke neurology in Italy  * Benefits of stroke unit care  * A Trojan Horse strategy  * Becoming a doctor and choosing neurology  * The focus on ICH  * Past trials and urgent unmet needs  * The gratitude of patients and their families  * The benefits of theatre  Find out more about the Angels Initiative: www.angels-initiative.com

A decade of Angels

The Angels Initiative is 10 years old. In a special birthday edition of the Angels Stroke Heroes podcast, we talk to project lead and cofounder Jan van der Merwe about a decade of Angels, the organization he and Thomas Fischer brought to life in May 2016.   Ten years later, the Angels Initiative has reached every goal, and exceeded every target.   It is estimated that more than 50 million stroke patients will receive evidence-based care in Angels hospitals by 2030.  With over 300,000 registered users on the Angels website, it is the world’s largest stroke community, a truly global movement that spans multiple continents including Europe, Africa, Asia, and Latin America. Over 200,000 courses have been completed in our online learning platform, the Angels Academy. World-wide, more than 9,000 hospitals and 1,000 prehospital teams have met the standard for hospital and EMS awards.   The target of 1,500 hospitals by December 2019 was reached in 2018, and the number of registered Angels hospitals now exceeds 10,000. The Angels-supported schools-based awareness program, FAST Heroes, has reached more than one million children and two million grandparents. And the strategy to convert 1000 Angels Regions by December 2027 overshot its target earlier this year.  We asked Jan about the tragic event that became a trigger for an extraordinary intervention in stroke care, about the strategic model that underpins the organization, and about doing things for the right reasons.   In this episode:   * God’s plan & doing things for the right reasons  * The devastating moment that led to the launch of Angels  * A multi-platform behavior change strategy  * Insights about complexity and time  * The real meaning of awards  * The power of communities  * A shocking experience that further shaped his understanding of the mission  * ‘They need not wait to see what others do’  * The next 10 years  Find out more about the Angels Initiative: www.angels-initiative.com

ICH care bundle – a call to action

Evidence that a combination of actions performed together can reduce death and disability in intracerebral haemorrhagic stroke (ICH) was a call to action for the Angels Initiative to devise a set of tools that supports and standardizes implementation.     That task fell to Madeline Bucher and Ines Carvalho who, in this episode of the Angels Stroke Heroes podcast, join us to tell the story of designing a checklist for change.    Intracerebral haemorrhage is the most serious and least treatable form of stroke. And while the past three to four decades saw great strides in the treatment of acute ischemic stroke, the fate of ICH patients remained largely unchanged, until the conclusion of studies such as the INTERACT3 clinical research project in 2023. INTERACT3 showed that timely administration of a care bundle that included lowering of systolic blood pressure, strict glucose control, treatment of fever, and rapid reversal of anticoagulation led to less disability, lower rates of death, and better overall quality of life.     During ESOC 2025, INTERACT3 lead investigator and WSO president-elect Prof Craig Anderson made the case for the care bundle in a panel discussion with Professors Pachi Moniche and Robert Mikulik that was initiated and recorded by Angels.     This discussion was the starting point for Madeline and Inês after they accepted a brief to create standardized tools to support the implementation of the ICH care bundle in hospitals.    In this episode  * A call to action  * What was in the brief  * A multi-platform strategy  * Scripting the critical moves  * Ask the experts  * The five platforms in action  * More science, please  Find out more about the Angels Initiative: www.angels-initiative.com