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Telestroke—the promise and the challenge. Part one: growth and current practice
  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 first of a detailed two part review, and explores the growth and current practice of telestroke, including the specific role it plays in the assessment and management of patients after emergent large vessel occlusion.

  • Stroke
  • Thrombolysis
  • Thrombectomy
  • History

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