Observational study of a regional inter-hospital telestroke network in the thrombectomy era (P5.250)

Objective: To describe an acute stroke network system and its clinical decisions. Background: Endovascular treatment in ischemic stroke with major vessel occlusion has been recently proved to be unequivocally beneficial. This progress has settled the need for a articulation between different level stroke units across the central region of Portugal, leading to the development of the first national structured telemedicine network for direct assessment of acute stroke patients. Design/Methods: Retrospective descriptive study enrolling patients evaluated by telemedicine at a tertiary center during the period between September 1 stst 2015 and November 30 rd th 2016. Cerebral hemorrhages were excluded. Results: From 479 telemedicine appointments, 448 patients were included: mean age 65.5±12.9 years; 50.1% male sex; mean presenting NIHSS 12.9±7.9 points. 98 patients (21.8%) were proposed to intravenous fibrinolysis and transferred for eventual endovascular treatment. 49 (10.9%) with some contraindication to IV treament were transferred to primary trombectomy benefit assessment. In 138 (30.8%) patients it was suggested IV treatment without further transfer. The remaining 163 (36.4%) which encompass 24 (5.4%) with stroke mimics, stayed at the origin facility for clinical surveillance without any other reperfusion treatment. During this period, 63 (32.5%) of the 194 patients submitted to endovascular treatment were referred from this network. Conclusions: The articulation between stroke units using telemedicine is feasible and effective. It seems to improve clinical resources usage by transferring potential thrombectomy candidates acutely and avoiding the unnecessary transport of the remaining. Disclosure: Dr. Varela has nothing to disclose. Dr. Santo has nothing to disclose. Dr. Machado has nothing to disclose. Dr. Goncalves has nothing to disclose. Dr. Saraiva has nothing to disclose. Dr. Sa has nothing to disclose. Dr. Gomes has nothing to disclose. Dr. Costa has nothing to disclose. Dr. Branco has nothing to disclose. Dr. Andre has nothing to disclose. Dr. Sargento-Freitas has nothing to disclose. Dr. Gandra de Almeida has nothing to disclose. Dr. Pimentel has nothing to disclose. Dr. Gomes da Costa has nothing to disclose. Dr. Cunha has nothing to disclose. Dr. Cunha has nothing to disclose.