Research
Neuroscience

Neurovascular Research Group

About

The Neurovascular Research Group has an experience of more than 20 years in multidisciplinary clinical-translational research in cerebral vascular pathology, with various cutting-edge clinical studies up to preclinical research at the molecular level and mechanisms of stroke.

This group was founded in 2006 by Dr Antoni Dávalos, and has been consolidated as a cerebrovascular diseases research group financed by Instituto de Salud Carlos III (ISCIII) from 2007 onwards. Since 2021, the team is led and coordinated by Dr Mònica Millán, current head of the Neurology Service of the Department of Neurosciences at Germans Trias i Pujol University Hospital (HUGTiP). The group is certified as a research team by AGAUR (2022) and is part of the RICORS-ictus network since 2021.

The Stroke Unit at HUGTiP, accredited by the Spanish Society of Neurology (SEN) and by the European Stroke Organization (ESO), treats more than 1,000 stroke patients a year. It is one of the centres with the highest volume of reperfusion treatment in Catalonia, annually treating 120 patients with intravenous therapy and 150 patients with thrombectomy, with optimal intrahospital organisation and time metrics.

The general objectives of the Neurovascular Research Group are to carry out an excellent research, to develop and participate in clinical trials, to deepen the knowledge of the results achieved so far in basic and clinical research, to communicate to society and to the scientific community, and most importantly, to transfer their knowledge to clinical practice in the care of patients with cerebrovascular diseases. Thus, the group’s researchers aim for socially responsible research and innovation, prioritising research with the greatest potential to generate benefit for society, patients and their families.

Keywords: stroke, thrombolysis, mechanical thrombectomy, endovascular treatment, intracranial hemorrhage, pre-hospital organization, neuroimaging, blood stroke biomarkers, neuroprotection, post-stroke care, cognition.

Neurovascular Research Group

Group leader

  • Mònica Millán Torné, MD, PhD
    Mònica Millán Torné, MD, PhD

    Mònica Millán Torné, MD, PhD

    Vascular neurologist, head of the Neuroscience Department, Germans Trias i Pujol University Hospital, Barcelona.

    Dr Mònica Millán graduated in Medicine and Surgery from Universitat Autònoma de Barcelona in 1994. She joined as a Neurology resident at Germans Trias i Pujol University Hospital (HUGTIP), finishing the specialty in 2000. Since then, she has developed her career clinical professional, undergraduate and postgraduate teacher, researcher and management at HUGTiP, initially as an associate physician with special interest in cerebral vascular pathology, later as head of the Vascular Neurology Section and currently as head of the Neurology Department since 2018. In August 2023, she was appointed by the hospital management as clinical director of Neurosciences.

    Dr Millán understands research as an inseparable binomial from the clinic, with the aim of improving the quality of life of patients with cerebral vascular diseases and that of their families. Among the developed lines of research, she has special interest in the role of iron in brain damage in patients with ischemic stroke (doctoral thesis), cerebral haemorrhage and in experimental studies stands out, as well as the neuroprotective role of iron chelators in cerebral ischemia (deferoxamine, apotransferrin) (Stroke 2007, Dis Markers 2008, Stroke 2010, Redox Biol 2018, Antioxidants 2022). Another line of research that Millán has developed is the demonstration of clinical benefit of mechanical thrombectomy (principal investigator of the REVASCAT study center, NEJM 2015), as well as the identification of clinical, radiological and procedural markers related to the clinical response of endovascular treatment in acute ischemic stroke.

    She is co-author of more than 130 scientific articles (19 as main, corresponding or senior author), has participated in the writing of eight chapters or monographs, has obtained five competitive clinical research projects as principal investigator and has collaborated as co-investigator in five other academic projects. In addition, she has been the local-PI of 13 international clinical trials and co-investigator of 32 clinical trials both in the field of the acute phase and secondary prevention in ischemic or hemorrhagic stroke.

    Her research activity is combined with undergraduate teaching activity as a professor at Universitat Autònoma de Barcelona and postgraduate (participation and organisation of specialised training courses), as well as with management responsibilities and care activity within the Neurology Department.

    Contact: mmillan.germanstrias(ELIMINAR)@gencat.cat
    ORCID: 0000-0002-4692-5936

Team

Alejandro Bustamante Rangel(ELIMINAR)
María Hernández Pérez(ELIMINAR)
Meritxell Gomis Cortina(ELIMINAR)
Laura Dorado Bouix(ELIMINAR)
Marina Martínez Sánchez(ELIMINAR)
Belén Flores-Pina(ELIMINAR)
Antoni Dávalos Errando(ELIMINAR)
Alicia Martínez Piñeiro(ELIMINAR)
Lucia Muñoz Narbona(ELIMINAR)
Martí Boix Coll(ELIMINAR)
Daniel Santana(ELIMINAR)
Jesús Juega(ELIMINAR)
Bárbara Yugueros(ELIMINAR)

Patricia Cuadras Collsamanta(ELIMINAR)
Paloma Puyalto De Pablo(ELIMINAR)
Cynthia María Cáceres Aguilar(ELIMINAR)
Carlos Hernán Castaño Duque(ELIMINAR)
Sebastià Remollo Friedemann(ELIMINAR)
Isabel Rodríguez Caamaño(ELIMINAR)
Carlos J. Domínguez Alonso(ELIMINAR)
Ana Rodríguez Hernández(ELIMINAR)
Alberto Blanco Ibañez(ELIMINAR)

Research lines

Therapies in patients with acute stroke

Neuroprotection

  • Development of a neuroprotective agent (aptamer) in phase IIb-III clinical trial to demonstrate the safety and clinical benefit in patients with ischemic stroke candidates for endovascular treatment (NEXTOLL Study).
  • Co-leadership in the RACETOLL study to evaluate the safety of the same aptamer drug as a neuroprotectant administered in the ambulance in the pre-hospital phase.
  • Development of a phase IIa/IIb clinical trial to evaluate the safety, dose determination and proof of concept of the benefit of apotransferrin in the treatment of ischemic stroke in patients treated with endovascular treatment.

Intravenous thrombolytic agents

  • Participation in multicentric studies that will demonstrate the therapeutic benefit of intravenous thrombolytic agents in patients under direct oral anticoagulation (DO-IT study).

Endovascular treatment

  • Demonstration of the safety of different technology and approaches for mechanical thrombectomy in acute stroke: AQUAS (Aperio Stent+ QTM Distal Aspiration Catheter), PIVOTAL study (Rapid pulse system). 
  • Demonstration of the benefit of intra-arterial tPA post-complete recanalization in stroke patients treated with mechanical thrombectomy as a collaborating center of the CHOICE-2 study.
  • Evaluation of the benefit of mechanical thrombectomy in new indications within international clinical trials, such as in patients with mild symptoms (MOSTE). 
  • Development of a non-invasive device that monitors N20 somatosensory potential wave as a physiological predictive marker of patients submitted to mechanical thrombectomy (PROMISE20 trial).
  • Participation in the SCREENING study to detect groin complications in stroke patients undergoing mechanical thrombectomy by using ecodoppler performed by the Stroke Unit nursing team.

Intracranial and Subaracnoïdal hemorrhage

  • Improvement of the prediction of mortality and functional prognosis to favor therapeutic decisions: Design and external validation of a novel and easier prognostic scale for mortality and functional recovery of patients with cerebral hemorrhage (PRO-ICH scale). To evaluate new blood biomarkers that improve the accuracy of this scale.  
  • Leadership in the development of a study of minimally invasive surgery.
  • Several study approaches focused on complications and prognosis of patients with Subaracnoidal Hemorrhage, providing clinical, neuroimaging and biological data.
  • Demonstration of the benefit of therapies with coagulation factors (recombinant FVII) as a collaborating center of the FASTEST trial study.
  • To evaluate the safety and benefit of maintenance of statins after intracerebral haemorrhage as a collaborating center of the SATURN trial study (funded by NIH). 

Territorial organisation for stroke care

Pre-hospital triage

  • Development of new tools for pre-hospital triage to identify stroke sub-type (ischemic, hemorrhage and mimic-stroke) in the ambulance, as an evolution of the RACE scale, developed and validated by the group (RACE-PLUS project).
  • Collaboration in international projects for the creation of artificial mathematical models through geomapping to define the optimal circuits in different geographical territories.

Multimodal neuroimaging techniques (CT and MR in acute stroke)

Patient selection for reperfusion treatment

  • Determination of the best multimodal neuroimaging (CT or MRI) for the selection of stroke patients with criteria for mechanical thrombectomy.
  • Determination of whether simple imaging techniques offer the same safety profile as advanced multimodal techniques in selecting patients for mechanical thrombectomy in an extended treatment window (VESTA trial).
  • Establishment of new neuroimaging algorithms to improve patient selection.

Radiological biomarkers

  • Study of mechanisms associated with cerebral infarction progression quantified with DWI lesion volume and radiological markers associated with clinical response and reperfusion damage (FURIAS trial).

Diagnostic and prognostic clinical and biological markers of stroke and its complications

Pneumonia associated with stroke (ELITE-SAP project)

  • Validation of a panel of blood biomarkers for the prediction and diagnosis of stroke-associated pneumonia.
  • Evaluation of pulmonary ultrasound for the prediction and diagnosis of pneumonia associated with stroke.
  • Characterisation of the bronchoalveolar lavage fluid in animal models of stroke and its relationship with the development of pulmonary infections.
  • Evaluation of new therapeutic targets and drugs for the prevention of pneumonia associated with stroke through the modulation of pulmonary immunity.

Cerebral thrombus analysis

  • To co-lead a national registry of thrombus removed from brain arteries to analyse its composition using artificial intelligence techniques that allows predicting the resistance to recanalization or its etiology, with the aim of being able to establish the optimal treatment approach.

Neurocardiology

Neurological complications of invasive cardiac procedures

  • Advanced neuropsychological and neuroimaging evaluation of the impact of cognitive impairment associated with different cardiac surgery techniques: aortic valve replacement through cardiac surgery vs transcatheter implantation (TAVI) (ARTICO study).

Identification of cardiac arrhythmias as a cause of stroke and prevention of cardioembolic stroke

  • SRA (Stroke Risk Analysis) technology. Determination of the incidence of paroxysmal atrial fibrillation in patients with undetermined etiology of the stroke in the follow-up detected with the SRA system.
  • Identification of echocardiographic factors in combination with factors obtained in cardiac monitoring using the SRA system that allow predicting patients with atrial fibrillation.
  • To evaluate the effect of early treatment of atrial fibrillation for stroke prevention in acute stroke (cardíac rhythm control) as a collaborating center of the EAST-STROKE study. 

Brain recovery and post-stroke care

  • Implementation and evaluation of integrated multilevel care systems to pursue improvement in post-stroke care at discharge, early detection of complications and uncovered needs, and improvement in quality of life and health status (CAMÍ project).
  • Incorporation of technological systems integrated into the IT systems that allow communication with the patient and family, management of expectations and collection of clinical results (PROMS and PREMS).
  • Identification of new predictive serum or genetic biomarkers of post-stroke complications, such as cognitive or mental health impairment.

Stroke prevention

  • Identification of mechanisms related to the development of active (high risk) atheroscleotic plaques in the RECAST study (external validation of the scale predictor of restenosis ≥ 70% post-angioplasty and stenting) as a collaborating center. The group has a retrospective database of more than 1000 patients with extracranial atherosclerotic pathology, with clinical, neuroimaging and neurosonological data.
  • Identification of risks factors associated with stroke in children and young adults as a collaborating center of the study "Effect of TLR4-Mediated Modulation of Inflammation in Reducing Brain Damage After Pediatric lschemic Stroke".
  • To evaluate the benefit of asundexian (a new type of anticoagulant that inhibits Factor XI) in the OCEANIC study and Milvexian in the LIBREXIA study to reduce stroke recurrences. 

Active projects

Grup de Recerca Neurovascular Germans Trias i Pujol (GRNV-GT)

PI: Mònica Millán Torné
Funding agency: Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR)
Agency code: 2021 SGR 00925
Duration: 2022 - 2025

RICORS-ICTUS

PI: Mònica Millán Torné
Funding agency: Instituto de Salud Carlos III (ISCIII)
Agency code: RD24/000/0024
Duration: 2025 - 2027

Project RACE / RACE-PLUS

PI: Natalia Pérez de la Ossa
Funding agency: Fundació "La Caixa" / Llegat GT / Fundació Ictus
Duration: 2023 – 2025

Geospatial modeling for stroke care

PI: Natalia Pérez de la Ossa
Funding agency: NIH-National Institute of Neurological Disorders and Stroke
Agency code: 1R01NS127114-01
Duration: 2022 - 2027

Tratamiento del ictus en Ventana Extendida: optimización de la Selección radiológica y el modelo de TrAslado en los pacientes con un ictus de 6-24h (estudio VESTA)

PI: María Hernández Pérez
Funding agency: Instituto de Salud Carlos III (ISCIII)
Agency code: PI21/01548
Duration: 2022 - 2025

Evaluación del daño pulmonar como diana terapéutica contra la neumonía asociada al ictus (ELITE-SAP)

PI: Alejandro Bustamante Rangel
Funding agency: Instituto de Salud Carlos III (ISCIII)
Agency code: PI21/00939
Duration: 2022 - 2025

Cirugía precoz y mínimamente invasiva en hematomas intracraneales: estudio translacional multicéntrico del papel de los biomarcadores iniciales en el daño cerebral secundario subagudo

PI: Ana Rodríguez
Funding agency: Instituto de Salud Carlos III (ISCIII)
Agency code: PI22/01290
Duration: 2023 – 2025

Past projects

Fecal incontinence after acute stroke (FINISH Study): understanding pathophysiological mechanisms and new frontiers in its treatment

PI: Mònica Millán Torné
Funding agency: Fundació La Marató TV3
Agency code: 201718.10
Duration: 2018 - 2022

NeuroToll - Desarrollo y validación clínica de un aptámero terapéutico para tratamiento del ictus isquémico agudo

PI: Antoni Dávalos Errando
Funding agency: Ministerio de Ciencia, Innovación y Universidades
Agency code: RTC-2017-6651-1
Duration: 2018 - 2022

ITACAT: Impact of Thrombus Analysis in stroke patients in CATalonia

PI: Laura Dorado Bouix
Funding agency: Fundació La Marató TV3
Agency code: 201719.31
Duration: 2018 - 2022

RICORS-ICTUS

PI: Mònica Millán Torné
Funding agency: Instituto de Salud Carlos III (ISCIII)
Agency code: RD21/0006/0024
Duration: 2022 - 2024

Blood-brain barrier dysfunction an oxidative stress modulation in brain arteriovenous malformations: a translational study of secondary injury after surgical resection

PI: Laura Dorado Bouix
Funding agency: Fundació La Marató TV3
Agency code: 202035.32
Duration: 2021 - 2024

BraiN20, the new standard of care to improve the management of Acute Ischemic Stroke (AIS) patients

PI: Alicia Martínez Piñeiro
Funding agency: Fundació "La Caixa"
Agency code: CC21-10016
Duration: 2021 - 2023

Evaluación Neuropsicológica y por Neuroimagen Avanzada del impacto del Deterioro Cognitivo en la Sustitución Valvular Aórtica Convencional comparada con el Implante Transcatéter

PI: Meritxell Gomis Cortina
Funding agency: Instituto de Salud Carlos III (ISCIII)
Agency code: PI19/01397
Duration: 2020 - 2023

Clinical trial to evaluate the administration of ApTOLL in ambulances and the neuroprotective effect in stroke patients. RACETOLL

PI: Natalia Pérez de la Ossa
Funding agency: Ministerio de Ciencia e Innovación
Agency code: CPP2021-008378
Duration: 2022 - 2024

Scientific publications

Highlighted publications

Bustamante A, Balboa M, Ezcurra G, Sánchez-Fortún A, Ruiz J, Castellví J, Castillo-Acedo S, Matas È, Bouchikh R, Martínez-Sánchez M, Castaño C, Remollo S, Werner M, Salgado MC, Villodres S, Gea M, Millán M, Pérez de la Ossa N, Ruiz-Bilbao S. Implementation of a retinal stroke-code protocol results in visual recovery in patients receiving reperfusion therapies. Eur Stroke J. 2024 Jun;9(2):486-493. DOI: 10.1177/23969873231221366.

Ramos-Pachón A, Rodríguez-Luna D, Martí-Fàbregas J, Millán M, Bustamante A, Martínez-Sánchez M, Serena J, Terceño M, Vera-Cáceres C, Camps-Renom P, Prats-Sánchez L, Rodríguez-Villatoro N, Cardona-Portela P, Urra X, Solà S, Del Mar Escudero M, Salvat-Plana M, Ribó M, Abilleira S, Pérez de la Ossa N, Silva Y; RACECAT Trial Investigators. Effect of Bypassing the Closest Stroke Center in Patients with Intracerebral Hemorrhage: A Secondary Analysis of the RACECAT Randomized Clinical Trial. JAMA Neurol. 2023 Oct 1;80(10):1028-1036. DOI: 10.1001/jamaneurol.2023.2754.

Hernández-Pérez M, Werner M, Remollo S, Martín C, Cortés J, Valls A, Ramos A, Dorado L, Serena J, Munuera J, Puig J, Pérez de la Ossa N, Gomis M, Carbonell J, Castaño C, Muñoz-Narbona L, Palomeras E, Domenech S, Massuet A, Terceño M, Davalos A, Millán M. Early and Delayed Infarct Growth in Patients Undergoing Mechanical Thrombectomy: A Prospective, Serial MRI Study. Stroke. 2023; 54: 217-225. DOI: 10.1161/STROKEAHA.122.039090.

Pérez de la Ossa N, Abilleira S, Jovin TG, García-Tornel Á, Jimenez X, Urra X, Cardona P, Cocho D, Purroy F, Serena J, San Román Manzanera L, Vivanco-Hidalgo RM, Salvat-Plana M, Chamorro A, Gallofré M, Molina CA, Cobo E, Davalos A, Ribo M; RACECAT Trial Investigators. Effect of Direct Transportation to Thrombectomy-Capable Center vs Local Stroke Center on Neurological Outcomes in Patients With Suspected Large-Vessel Occlusion Stroke in Nonurban Areas: The RACECAT Randomized Clinical Trial. JAMA. 2022 May 10;327(18):1782-1794. DOI: 10.1001/jama.2022.4404. Erratum in: JAMA. 2023 Apr 4;329(13):1123. DOI: 10.1001/jama.2023.3946.

Millán M, Ramos-Pachón A, Dorado L, Bustamante A, Hernández-Pérez M, Rodríguez-Esparragoza L, Gomis M, Remollo S, Castaño C, Werner M, Wenger D, Rubio S, Domínguez-Lizarbe M, Terceño M, Paipa AJ, Rodríguez-Vázquez A, Boned S, Camps-Renom P, Cánovas D, Giralt E, López-Cancio E, Dávalos A, Ros-Roig J, Pérez de la Ossa N; Cat-SCR Consortium. Predictors of Functional Outcome After Thrombectomy in Patients With Prestroke Disability in Clinical Practice. Stroke. 2022 Mar;53(3):845-854. DOI: 10.1161/STROKEAHA.121.034960.

ALL PUBLICATIONS

Additional information

Collaborative networks

  • The Neurovascular Research Group's philosophy is to collaborate in the clinical or basic research with other national and international research groups. The active participation in more than 35 multicenter clinical studies in the last 6 years and the direction and leadership of some of these studies by members of the group (REVASCAT, RACECAT, ELITE-SAP, VESTA study, PROMISE 20) are an example of this commitment.
  • At the national level, the group is part of the national research network "Redes de Investigación Cooperativa RICORS en Enfermedades Vasculares Cerebrales - RICORS-ICTUS (RD24/0015)". This network funded by Instituto Carlos III includes 23 national research centers, and aims to develop translational research with a collaborative vision. More information 
  • The research group also collaborates in the Catalan Stroke and Reperfusion Code Consortium (SCR-Cat), made up of the 29 stroke care centers in Catalonia, with the inclusion of patients in the Catalan stroke code register (CICAT registry) and the use of multicenter data for clinical research. The consortium has generated more than 30 publications in the last 6 years, 6 of them led by members of the group.
  • The group also establishes collaborations with other national and international stroke expert groups on advanced neuroimaging (Hospital Clínic, Hospital Universitari de Valladolid) and in the development of algorithms and geo-spatial maps to predict the most effective care circuits (collaboration with University of Iowa, funded by the US NIH Institute and University of Canada). The group maintains continuous collaboration with Dr Tudor Jovin, key opinion leader in the treatment of acute stroke.

Doctoral theses

Title: Determinació de variables pronòstiques de mortalitat i recuperació funcional en hemorràgia intracerebral
Author: Anna Ramos
Supervisors: Mònica Millàn, Maite Missis
University: Universitat Autònoma de Barcelona (UAB)
Date of defense: 27/10/2023

Title: Evaluación Neuropsicológica y por Neuroimagen avanzada del impacto del deterioro cognitivo en la sustitución valvular aórtica convencional comparada con el implante transcatéter (ARTiCO)
Author: Claudio Fernández
Supervisor: Meritxell Gomis
University: Universitat Autònoma de Barcelona (UAB)
Currently under preparation

Title: Evaluación del daño pulmonar como diana terapéutica en la neumonía asociada al ictus
Author: Diego Sahuquillo Barros
Supervisor: Alejandro Bustamante
University: Universitat Autònoma de Barcelona (UAB)
Currently under preparation

Title: Marcadores radiológicos evolutivos en el ictus agudo por oclusión de gran vaso: fenómeno de no reflow y rotura de barrera hematoencefálica
Author: Adrián Valls Carbó
Supervisor: María Hernández-Pérez
University: Universitat Autònoma de Barcelona (UAB)
Currently under preparation

Title: Caracterización del realce post-contraste como marcador de actividad inflamatoria de las placas de aterosclerosis intracraneal. Estudio Clínico-Básico
Author: Beatriz Gómez Vicente
Supervisor: Maria Hernández-Pérez
University: Universidad de Valladolid
Date of defense: 12/05/2023

Title: Factores relacionados con la aparición de fibrilación auricular, insuficiencia cardíaca, y su pronóstico en Cataluña
Author: Felipe González Loyola
Supervisor: Alejandro Bustamante
University: Universitat Autònoma de Barcelona (UAB)
Date of defense: 22/5/2024

Title: Predicción y diagnóstico de la neumonía asociada al ictus mediante biomarcadores ecográficos y sanguíneos
Author: Marina Martínez
Supervisors: Alejandro Bustamante, Natalia Pérez de la Ossa
University: Universitat Autònoma de Barcelona (UAB)
Currently under preparation

Innovation 

  • Time is Brain: Time is Brain is spin-off from IGTP created in 2020. The team developed BraiN20, a medical device which hopes to be the new standard of care to improve the management of Acute Ischemic Stroke (AIS) patients. PIs: Alicia Martínez-Piñeiro and Antoni Dávalos. More information
  • Some of the team members participate in advisory activities to biomedical and pharmaceutical companies in the development of diagnostic devices and therapeutic strategies, such as the company Methinks, aptaTargets. They also actively participates in training activities, presentations, and advisory activities for different initiatives as the Angels Initiative which acts at a global level in the establishment of health systems and training professionals for the improvement of care stroke.

Outreach 

  • They participate in undergraduate medical training by coordinating the Clinical Neurology course, as well as hospital internships. The group supervises and tutors medical students' final degree projects (M. Millán).
  • They offer postgraduate training within the resident internship program, with three residents per year. The group offers specific training programs in vascular neurology and interventional neuroradiology for fellowships, having trained more than 10 fellows in the last 10 years.
  • They organise and develop various continuing teaching activities for healthcare professionals, such as the "Update on Cerebral Vascular Pathology" course, the "Neurosciences: Innovation and Research" course, and the "Painad Pain Scale adapted to hospitalized patients in acute care units”, accredited by the Catalan Council for Continuing Education of Health Professions. Additionally, weekly training sessions are held for stroke patients and their families, and a training session is held in the hospital auditorium for patients, family members, and the general public, coinciding with World Stroke Day.
  • Group members participate in other research activities as members of various scientific committees or clinical trial safety committees, are part of scientific societies and collaborate as editors of international journals (Frontiers in Neurology, SVIN, others).

News

- Institutional, Campus Can Ruti, Success Stories

Can Ruti Campus remains a globally significant scientific centre due to its medical and research staff

Once again, the names of around thirty renowned professionals - from the Hospital and the Germans Trias i Pujol Research Institute (IGTP), the Fight Infections Foundation, IrsiCaixa, the Josep Carreras Leukaemia Research Institute (IJC), and the Institut Català d'Oncologia (ICO) - appear on a global list of scientists who have achieved the highest impact through their publications and citations.

- Research

The application of a retinal stroke coding protocol improves visual recovery in patients receiving reperfusion therapies

The 'Retina Stroke Code' acts against a type of stroke that can cause irreversible vision loss if not addressed within 6 hours. It is unique in Catalonia and has proven crucial over five years for recovering visual acuity and preventing worse complications in patients at Germans Trias Hospital.

+ News