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Telestroke—the promise and the challenge. Part two—expansion and horizons
  1. F Akbik1,
  2. J A Hirsch2,3,
  3. R V Chandra4,
  4. D Frei5,
  5. A B Patel3,6,
  6. J D Rabinov2,3,
  7. N Rost1,
  8. L H Schwamm1,
  9. T M Leslie-Mazwi1,3
  1. 1Department of Stroke Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2Department of Interventional Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Department of Neuroendovascular, Massachusetts General Hospital, Boston, Massachusetts, USA
  4. 4Department of Neuroendovascular, Monash University Hospital, Melbourne, Australia
  5. 5Department of NeuroInterventional Surgery, Radiology Imaging Associates/RIA Neurovascular, Swedish Medical Center, Englewood, Colorado, USA
  6. 6Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr T M Leslie-Mazwi, GRB 2-241, 55 Fruit Street, Boston, MA 02114, USA; tleslie-mazwi{at}


Acute ischemic stroke remains a major public health concern, with low national treatment rates for the condition, demonstrating a disconnection between the evidence of treatment benefit and delivery of this treatment. Intravenous thrombolysis and endovascular thrombectomy are both strongly evidence supported and exquisitely time sensitive therapies. The mismatch between the distribution and incidence of stroke presentations and the availability of specialist care significantly affects access to care. Telestroke, the use of telemedicine for stroke, aims to surmount this hurdle by distributing stroke expertise more effectively, through video consultation with and examination of patients in locations removed from specialist care. This is the second of a two part review, and is focused on the challenges telestroke faces for wider adoption. It further details the anticipated evolution of this novel therapeutic platform, and the potential roles it holds in stroke prevention, ambulance based care, rehabilitation, and research.

  • Stroke
  • Thrombolysis
  • Thrombectomy
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