Telestroke vs Phone Consultation in Stroke Patients Eligible for Intra-Arterial Therapy (P6.033)

BACKGROUND AND OBJECTIVE: Intra-arterial therapy (IA) is beneficial for acute ischemic stroke patients with large vessel occlusions who have received intravenous tissue plasminogen activator (IVtPA). We sought to determine whether telestroke improved the process in evaluation and transfer of patients who may be eligible for intra-arterial therapy (IA). METHODS: The Rush telestroke program consists of a comprehensive stroke center that serves 10 spoke emergency-departments (EDs). For sites outside of the telestroke program, the patient receives telephone consultation from the same pool of telestroke neurologists. IA theray is considered for patients clinnically suspected of having a large vessel occlusion who could potentially be treated with IA within 6 hours of last known normal. We compared IA eligible stroke patients transferred via the telestroke program to those non-telestroke transfer patients. RESULTS: From July 1, 2013 to July 1, 2015, 126 patients were transferred from outside hospital EDs to our institution for potential IA. Among 119 patients, 79 (66[percnt]) were evaluated via telestroke and 40 (34[percnt]) via phone consultation. There was no difference between groups for hypertension (66[percnt] vs 78[percnt], p 0.21), atrial fibrillation (27[percnt] vs 20[percnt], p=0.50), initial arrival NIHSS (17 vs 19, p=0.12), frequency of IA (66[percnt] vs 55[percnt], p=0.31), mean time from LKN to IVtPA administration (139 vs 138 minutes, p=0.96), mean time from IVtPA administration to arrival (106 vs 94 minutes, p=0.31), mean time from arrival to IA start (35 vs 31 minutes, p=0.44) or the demographics of age and gender. More patients who were evaluated via telestroke received TPA compared to phone (80[percnt] vs 63[percnt], p<0.05). CONCLUSIONS: Telestroke improves the evaluation of IA eligible stroke transfer patients by increasing the rates of IVtPA compared with telephone consultation alone. Comprehensive stroke centers may benefit patients by incorporating telestroke systems into their IA transfer programs. Disclosure: Dr. Osteraas has nothing to disclose. Dr. Conners has nothing to disclose. Dr. Cutting has nothing to disclose. Dr. Song has nothing to disclose. Dr. Cherian has nothing to disclose. Dr. Diebolt has nothing to disclose. Dr. Bock has nothing to disclose. Dr. Lee has nothing to disclose.