BACKGROUND: The benefit of tissue plasminogen activator (t-PA) is strongly associated with the time to treatment. In Bavaria, Germany, only half of the population has the opportunity to be transferred to 1 of the 19 stroke units within the critical time window of less than 3 hours. The aim of this study was to investigate the benefit of a new stroke-code-box for t-PA thrombolysis combined with a telemedicine network system to increase the use of acute stroke thrombolysis. METHODS: Two specialized stroke centers in Germany established a 24-hour telemedicine network (Telemedicine Pilot Project of an Integrated Stroke Care [TEMPiS]) to advise 12 community hospitals in eastern Bavaria. These clinics are linked via telemedicine in a 24-hour/7-day service network that allows patients to be examined by experts via a videoconference system Additionally, a special stroke-code-box for acute t-PA thrombolysis was designed to reduce time in the application and documentation process. RESULTS: In the 12-month period before implementation of the TEMPiS network system, 10 patients had received systemic thrombolysis. In our 6-month study period (from July to December 2003) and after implementation of a stroke-code-box for t-PA thrombolysis within the telestroke network, 164 patients with acute stroke were presented with t-PA treatment indications. Of this patient population, 27.4% (45 of 164) received t-PA. CONCLUSIONS: Stroke care, including t-PA thrombolysis in non-urban areas, is feasible using a modern stroke unit concept within a telestroke network. With the expertise of specialized stroke centers accessed via telemedicine and the design of a stroke-code-box for t-PA thrombolysis, nearly one-third of patients presented with a possible indication for systemic thrombolysis can be treated with t-PA, thereby increasing the options for a successful stroke treatment.
BACKGROUND: The benefit of tissue plasminogen activator (t-PA) is strongly associated with the time to treatment. In Bavaria, Germany, only half of the population has the opportunity to be transferred to 1 of the 19 stroke units within the critical time window of less than 3 hours. The aim of this study was to investigate the benefit of a new stroke-code-box for t-PA thrombolysis combined with a telemedicine network system to increase the use of acute stroke thrombolysis. METHODS: Two specialized stroke centers in Germany established a 24-hour telemedicine network (Telemedicine Pilot Project of an Integrated Stroke Care [TEMPiS]) to advise 12 community hospitals in eastern Bavaria. These clinics are linked via telemedicine in a 24-hour/7-day service network that allows patients to be examined by experts via a videoconference system Additionally, a special stroke-code-box for acute t-PA thrombolysis was designed to reduce time in the application and documentation process. RESULTS: In the 12-month period before implementation of the TEMPiS network system, 10 patients had received systemic thrombolysis. In our 6-month study period (from July to December 2003) and after implementation of a stroke-code-box for t-PAthrombolysis within the telestroke network, 164 patients with acute stroke were presented with t-PA treatment indications. Of this patient population, 27.4% (45 of 164) received t-PA. CONCLUSIONS:Stroke care, including t-PA thrombolysis in non-urban areas, is feasible using a modern stroke unit concept within a telestroke network. With the expertise of specialized stroke centers accessed via telemedicine and the design of a stroke-code-box for t-PA thrombolysis, nearly one-third of patients presented with a possible indication for systemic thrombolysis can be treated with t-PA, thereby increasing the options for a successful stroke treatment.
Authors: Peter U Heuschmann; Klaus Berger; Bjoern Misselwitz; Peter Hermanek; Carsten Leffmann; Michael Adelmann; Hans-Joachim Buecker-Nott; Joachim Rother; Bernhard Neundoerfer; Peter L Kolominsky-Rabas Journal: Stroke Date: 2003-03-27 Impact factor: 7.914
Authors: Heinrich J Audebert; Christian Kukla; Stephan Clarmann von Claranau; Johannes Kühn; Bijan Vatankhah; Johannes Schenkel; Guntram W Ickenstein; Roman L Haberl; Markus Horn Journal: Stroke Date: 2004-12-29 Impact factor: 7.914
Authors: H P Adams; T G Brott; A J Furlan; C R Gomez; J Grotta; C M Helgason; T Kwiatkowski; P D Lyden; J R Marler; J Torner; W Feinberg; M Mayberg; W Thies Journal: Stroke Date: 1996-09 Impact factor: 7.914
Authors: M Skorning; S Bergrath; D Rörtgen; J C Brokmann; S K Beckers; M Protogerakis; T Brodziak; R Rossaint Journal: Anaesthesist Date: 2009-03 Impact factor: 1.041
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Authors: Maarten M H Lahr; Gert-Jan Luijckx; Patrick C A J Vroomen; Durk-Jouke van der Zee; Erik Buskens Journal: J Neurol Date: 2012-08-23 Impact factor: 4.849
Authors: Bart M Demaerschalk; Madeline L Miley; Terri-Ellen J Kiernan; Bentley J Bobrow; Doren A Corday; Kay E Wellik; Maria I Aguilar; Timothy J Ingall; David W Dodick; Karina Brazdys; Tiffany C Koch; Michael P Ward; Phillip C Richemont Journal: Mayo Clin Proc Date: 2009 Impact factor: 7.616
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