Stroke patients in rural hospitals can receive safe, effective treatment with a clot-busting U drug when an expert from a larger hospital guides the therapy over the telephone.
"Expert guidance of this treatment over the telephone appears to be safe, practical and effective," according to study author Dr. Anand Vaishnav, of the University of Kentucky Medical Center in Lexington.
The Study
The study included 121 ischemic stroke patients treated with the clot-busting drug tissue plasminogen activator (PA) at a rural community hospital. Treatment was guided via phone by a stroke neurologist from a larger center.
To be effective, tPA must be given within three hours of a stroke. On average, the patients in this study started receiving tPA therapy within 132 minutes of stroke onset.
"This is less time than the average 144 minutes it took from stroke onset to tPA treatment in the National Institute of Neurological Disorders and Stroke (NINDS) PA study, which was a large national study in 1995. We also had lower rates of bleeding in the brain and death than the original NINDS study," Vaishnav said.
Background Study
In the original NINDS study, 6.4% of patients had symptomatic bleeding in the brain, compared with 2.5% of the rural patients in this study The patient death rate in the NINDS study was 17%, compared with 7.5% in this new study.
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