• We all know that intravenous thrombolysis has to become widespread to achieve any kind of success in our fight against stroke. However our efforts had been marred by the shortage of trained and certified neurologists who could thrombolyse. This new paper must be considered a landmark as it proves that IV thombolysis can be done 
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• Click to see the article abstract in the journal site​

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Telestroke-Guided Intravenous Tissue-Type Plasminogen Activator Treatment Achieves a Similar Clinical Outcome as Thrombolysis at a Comprehensive Stroke Center

1. Syed F. Zaidi, MD; 
2. Mouhammad A. Jumma, MD; 
3. Xabier N. Urra, MD;
4. Maxim Hammer, MD; 
5. Lori Massaro, CRNP; 
6. Vivek Reddy, MD; 
7. Tudor Jovin, MD; 
8. Ridwan Lin, MD, PhD; 
9. Lawrence R. Wechsler, MD

Correspondence to Lawrence R. Wechsler, MD, Professor and Chair, Department of Neurology, University of Pittsburgh, 3471 Fifth Avenue, 811 LK Building, Pittsburgh, PA 15213. E-mail wechslerlr@upmc.edu​

Abstract

Background and Purpose—

Telestroke networks offer an opportunity to increase tissue-type plasminogen activator use in community hospitals.

Methods—

We compared 83 patients treated with intravenous tissue-type plasminogen activator by telestroke to 59 patients treated after in-person evaluation by the same neurologists at a tertiary care stroke center. Onset and door-to-treatment times and functional outcome at 90 days were obtained prospectively. Favorable outcome was defined as modified Rankin Scale score ≤2.

Results—

Favorable outcome rates were comparable between the groups (42.1% versus 37.5%, P=0.7). There was no significant difference in the rate of symptomatic hemorrhage.

Conclusions—

Telestroke is a viable alternative to in-person evaluation when stroke expertise is not readily available.

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