First experience of international proctoring hands-on stroke course using Tegus telemedical system for overcoming education challenges during the war in Ukraine.

Interventional neuroradiology (INR) has not yet received official certification as a surgical subspecialty in Ukraine. Consequently, there is uncertainty surrounding the availability of a neurosurgical internship and a structured INR training program to provide neuroendovascular procedures. In recent years, mechanical thrombectomy has become the standard of care for acute ischemic stroke caused by large vessel occlusion, as supported by evidence-based guidelines. This emphasizes the need for INR specialists, which far exceeds the current supply. Although stroke centres with interventional neuroradiological facilities have been established to address this shortage in Ukraine, they lack highly skilled staff. Following the relaxation of COVID-19 migration restrictions, the Ukrainian medical system faced new limitations due to ongoing wartime conditions. In such circumstances, international cooperation becomes crucial to ensuring the safe and effective implementation of new technologies into routine medical practice. We successfully integrated teleproctoring into our hands-on course and found it to be an effective and promising approach, especially considering the uncertainty of the future and the presence of wartime migration restrictions in Ukraine. Teleproctoring hands-on course has the potential to provide young specialists with experienced mentors and valuable initial experience and can serve as a valuable adjunct for the improvement of surgeons confidence.