Evaluation of a Telephone Advice System for Remote Intravenous Thrombolysis in Ischemic Stroke
Data From a United Kingdom Network
Background and Purpose—There is limited evidence for remote stroke thrombolysis using telephone consultation and teleradiology. Results from a UK network using this treatment model are presented.
Methods—Retrospective study of consecutive patients thrombolysed in 5 hospitals, with well organized stroke services, between 2012 and 2013. Remote thrombolysis was compared with thrombolysis delivered in person for symptomatic intracerebral hemorrhage, death within 7 days, and 90-day modified Rankin scores.
Results—Of 586 patients, 220 (37.5%) were thrombolysed remotely. The 2 groups were well matched (median age 77 years, NIHSS 12). Remote thrombolysis increased treatment time by 22 minutes. Outcomes were no different in the 2 groups (remote versus standard): symptomatic intracerebral hemorrhage (3.6% versus 4.6%), death within 7 days (6.4% versus 7.1%), modified Rankin score <2 (46.0% versus 46.1%), and modified Rankin score 6 (15% versus 17.5%) at 90 days.
Conclusion—Telephone advice and teleradiology, within an organized system of care, can be an effective method of delivery of intravenous thrombolysis.
- Received November 20, 2014.
- Revision received December 17, 2014.
- Accepted December 22, 2014.
- © 2015 American Heart Association, Inc.