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Reperfusion Network

The Ukrainian government is carrying out an initiative that aims to improve urgent cardiology quality and develop regional reperfusion networks to provide free stenting in emergency cases of acute myocardial infarction. The co-financing model will provide for the state procurement of the necessary angiography equipment and free-of-charge urgent stenting to patients with symptoms of acute myocardial infarction.



For years, Ukraine has been 'the leader' among all European countries in terms of mortality rates from cardiovascular diseases. Over 40,000 people in Ukraine suffer from heart attacks each year and about 14% of heart attack patients die. Meanwhile, urgent stenting can prevent 21% of such deaths.

The European Society of Cardiology (ESC) estimated that in 2017 about 16,000 acute myocardial infarction patients in Ukraine needed emergency stenting. To put this in perspective, only 6,800 stent placement procedures were performed in 2016.

For the first time in the country's history, an international organization controlled the centralized procurement of stent systems and medical supplies to ensure that every patient who needs urgent angiography / stenting will receive such services FREE-OF-CHARGE.

The Government approved Resolution of the Cabinet of Ministers of Ukraine No.185 dated February 21, 2017 ‘On Approval of the Procedure and Conditions for the Provision of Subventions from the State Budget to Local Budgets for the Purchase of Angiography Equipment’ that provides for the purchase of stationary angiography equipment under the terms of co-financing from local budgets.

Our aim is to develop a network of regional reperfusion centers, which shall fundamentally change the system of urgent care for patients with acute myocardial infarction symptoms. However, the effective network functioning does not only depend on the availability of angiography equipment, but more importantly on the efficient coordinated work of all units – emergency first aid, reperfusion centers and cardiac care departments that ensure postoperative rehabilitation of patients.



Each reperfusion center should ensure 24/7/365 care delivery (i.e. operate 24 hours a day, 7 days a week, 365 days a year). All patients who need urgent stenting should be provided with timely diagnosis, and free-of-charge effective treatment. According to the European clinical practice guidelines, to maximize the effect of the procedure and subsequent effective rehabilitation, urgent stenting should be performed within the first 2 hours from the initial patient contact with medical staff (or within 12 hours after the onset of symptoms).

As of mid-2017, there were 22 reperfusion centers in 18 oblasts of Ukraine. Regional reperfusion centers are located on the territory of the country so that it is possible to deliver a patient in time by an ambulance (or by car) during the first 2 hours. To ensure a full load and timely assistance, each reperfusion center should work for 0.3-1 million people in the 24/7/365 mode.

Reperfusion centers constitute only one component of the entire system. Therefore, it is important to regulate and coordinate work of all urgent care delivery services and ensure that all units have enough ECG systems and defibrillators, permanent telephone connection with reperfusion centers and cardiac care departments, and that healthcare professionals are trained in full compliance with modern clinical practice guidelines and treatment protocols.

The activities of reperfusion centers are aimed at, among other, reducing the mortality rates in patients with acute coronary syndrome. Today, in-hospital mortality rates from myocardial infarction in clinics that are already functioning as reperfusion centers decreased to 3-6%.



Patients with signs and symptoms of acute myocardial infarction (AMI is the initial stage; the sharpest phase of AMI is called acute coronary syndrome with ST-segment elevation or STEMI) should seek treatment by calling 103 emergency number, especially in cases when types of transportation other than an ambulance are unavailable.

If AMI is confirmed in the first hours after the initial onset of symptoms, it is important to provide assistance within the first 12 hours (in some cases 24 hours) after the onset of symptoms – the sooner, the better. To maximize the effect of the procedure and to ensure subsequent effective rehabilitation, a patient has to be delivered to the RC within the first 2 hours from the initial contact with medical staff.

Then, a team of interventional cardiologists shall carry out a stenting procedure.

Stent placement (stenting) is a procedure for the placement of a small wire mesh tube (stent) within the blood vessel to help keep it open (mechanical removal of thrombus or atherosclerotic plaque) and restore blood flow.

A timely and effective reperfusion procedure usually ensures quick patient recovery, and,  depending on the severity of one's condition, patients can be discharged from the RC in a few days and continue rehabilitation on an outpatient basis.

  • What is Stenting?

    Stent placement (stenting) is a procedure for the placement of a small wire mesh tube (stent) within the blood vessel to help keep it open (mechanical removal of thrombus or atherosclerotic plaque) and restore blood flow.

  • What is a Reperfusion Center?

    Reperfusion Center is a specialized healthcare unit that works in the 24/7/365 mode to ensure timely and effective stenting in emergency cases of acute myocardial infarction.

  • How many reperfusion centers are currently open and carry free-of-charge stenting in Ukraine?

    There are 22 reperfusion centers in 18 oblasts of Ukraine that operate 24/7/365 to ensure timely treatment and stenting in emergency AMI/STEMI cases. We are planning to open 13 new reperfusion centers by the end of 2018.

    Today, a total of 44 healthcare facilities in Ukraine carry stenting procedures.

  • How can one get treatment free-of-charge? What is the difference between urgent (free-of-charge) and pre-scheduled stenting and who is given the priority in receiving stent?

    Free-of-charge treatment is provided in medical emergency cases, when an ambulance delivers to the hospital/RC a patient who needs urgent care. Priority should be given to patients with urgent health needs (in emergency cases). All necessary medical supplies and essential medicines have already been procured under the national Cardiovascular Disease Control Program and are intended for treatment of AMI/STEMI patients.

  • What is the average annual MI incidence rate in Ukraine?

    According to the Center for Health Statistics of the Ministry of Health of Ukraine, approximately 40,000 myocardial infarction cases are registered in Ukraine on an annual basis.