Telestroke service increases rates of 'clot-buster' treatment for stroke, reports Neurosurgery

Posted: Published on October 1st, 2013

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Public release date: 1-Oct-2013 [ | E-mail | Share ]

Contact: Connie Hughes connie.hughes@wolterskluwer.com 646-674-6348 Wolters Kluwer Health

Philadelphia, Pa. (October 1, 2013) A telestroke service increases the rate of effective tissue plasminogen activator (tPA) therapy for patients with acute ischemic stroke treated at community hospitals, according to a report in the October issue of Neurosurgery, official journal of the Congress of Neurological SurgeonsCongress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Other studies in the October Neurosurgery find that known gene variants don't affect the size of brain aneurysms and that surgery for a brain defect called Chiari malformation I (CMI) improves outcomes important to patients.

Remote Stroke Service Increases tPA Use at Community Hospitals

Dr. Stavropoula Tjoumakaris and colleagues of Thomas Jefferson University Hospital evaluated the effects of a telestroke network including 28 community hospitals in the Philadelphia area. In the network, stroke specialists used "remote presence" technology to consult on the care of stroke patients seen at hospitals that didn't have a specialized stroke unit. The study evaluated the rate of appropriate treatment with tPAan effective "clot-busting" drug that can be given only within the first few hours after initial stroke symptoms.

Over 18 months, the service provided nearly 1,650 remote stroke consultations; the average time from request to telemedicine response was just 12 minutes. About 14 percent of patients received tPAincluding nearly all of those who could be treated in the appropriate time window. By comparison, national data suggest that only three to five percent of patients with ischemic stroke receive tPA.

About 80 percent of network hospitals increased their use of tPA for acute ischemic stroke. The percentage of patients transferred to a specialized stroke center decreased as wellpossibly because patients began to improve at their original hospital. The researchers conclude, "The results support the implementation of telestroke networks for wider access to stroke expertise in underserved regions."

Gene Variants Show Little Effect on Aneurysm Size

Dr. Rachel Kleinloog and colleagues of Medical Center Utrecht, The Netherlands, looked for evidence of the effects of gene variants on the size of brain aneurysms. The study included two groups totaling nearly 1,000 patients with ruptured aneurysms of blood vessels supplying the brain.

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Telestroke service increases rates of 'clot-buster' treatment for stroke, reports Neurosurgery

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