2022
Spoke‐Administered Thrombolysis Improves Large‐Vessel Occlusion Early Recanalization: The Real‐World Experience of a Large Academic Hub‐and‐Spoke Telestroke Network
Kraft A, Regenhardt R, Awad A, Rosenthal J, Dmytriw A, Vranic J, Bonkhoff A, Bretzner M, Hirsch J, Rabinov J, Stapleton C, Schwamm L, Singhal A, Rost N, Leslie‐Mazwi T, Patel A. Spoke‐Administered Thrombolysis Improves Large‐Vessel Occlusion Early Recanalization: The Real‐World Experience of a Large Academic Hub‐and‐Spoke Telestroke Network. Stroke Vascular And Interventional Neurology 2022, 3 PMID: 36816048, PMCID: PMC9936963, DOI: 10.1161/svin.122.000427.Peer-Reviewed Original ResearchIntravenous thrombolysisMechanical thrombectomyEarly recanalizationInterhospital transferLarge vessel occlusion strokeLack of efficacyReal-world analysisVessel imagingEligible patientsMedian ageOcclusion strokeRecent trialsStroke NetworkTelestroke networkInclusion criteriaPatientsIVT useReal-world experienceNIHSSThrombolysisRecanalizationHospitalLVOImagingER ratesIn a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes
Kraft A, Awad A, Rosenthal J, Dmytriw A, Vranic J, Bonkhoff A, Bretzner M, Hirsch J, Rabinov J, Stapleton C, Schwamm L, Rost N, Leslie-Mazwi T, Patel A, Regenhardt R. In a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes. Interventional Neuroradiology 2022, 29: 315-320. PMID: 35317663, PMCID: PMC10369105, DOI: 10.1177/15910199221087498.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIntravenous thrombolysisIVT-treated patientsMechanical thrombectomyProcedure timePuncture timeImproved reperfusionBaseline characteristicsTICI 2bIVT patientsOcclusion strokeOperative reportsProcedural characteristicsTelestroke networkPatientsReperfusionIncreased proportionThrombolysisTechnical difficultiesNIHSSThrombectomyHospitalStrokeMin
2021
National Trends in Telestroke Utilization in a US Commercial Platform Prior to the COVID-19 Pandemic
Zachrison KS, Sharma R, Wang Y, Mehrotra A, Schwamm LH. National Trends in Telestroke Utilization in a US Commercial Platform Prior to the COVID-19 Pandemic. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106035. PMID: 34419836, PMCID: PMC8494566, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106035.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCOVID-19Databases, FactualFemaleFibrinolytic AgentsHumansMaleMiddle AgedPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareRemote ConsultationStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsIschemic stroke patientsTelestroke consultationAlteplase deliveryStroke patientsNumber of patientsNumber of consultsCOVID-19 public health emergencyPublic health emergencyAlteplase useMedian doorNeedle timeStroke severityED arrivalEmergency departmentImaging reviewHospital characteristicsTelestroke networkCT scanHospital participationSpoke sitesProvider groupsPatientsHospital sizeStudy periodHealth emergencyCTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals
Yu A, Regenhardt R, Whitney C, Schwamm L, Patel A, Stapleton C, Viswanathan A, Hirsch J, Lev M, Leslie-Mazwi T. CTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals. American Journal Of Neuroradiology 2021, 42: 435-440. PMID: 33541900, PMCID: PMC7959422, DOI: 10.3174/ajnr.a6950.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomySpoke hospitalsTelestroke networkHub hospitalCTA protocolHealth Stroke Scale scoreEmergent large vessel occlusionStroke Scale scoreRate of patientsLarge vessel occlusionCTA utilizationThrombectomy ratesStroke triageThrombectomyNonsignificant increasePatientsScale scoreHospitalTriage processNational InstituteOverall rateCTAExtended windowHigher numberRetention rate
2020
Acute ischemic stroke: improving access to intravenous tissue plasminogen activator
Turner A, Schwamm L, Etherton M. Acute ischemic stroke: improving access to intravenous tissue plasminogen activator. Expert Review Of Cardiovascular Therapy 2020, 18: 277-287. PMID: 32323590, DOI: 10.1080/14779072.2020.1759422.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic stroke patientsIschemic strokeStroke patientsTreatment windowAcute ischemic stroke patientsIntravenous tissue plasminogen activatorTreatment ratesUnknown symptom onsetAcute stroke careTissue plasminogen activatorQuality improvement initiativesHealth care resourcesUnited States FoodStroke outcomeSymptom onsetStroke careStroke specialistsStroke systemsTelestroke networkDrug AdministrationAlteplasePatientsPlasminogen activatorStates FoodTelemedicine and Telestroke
Zachrison K, Estrada J, Schwamm L. Telemedicine and Telestroke. Current Clinical Neurology 2020, 285-292. DOI: 10.1007/978-3-030-36548-6_20.Peer-Reviewed Original Research
2018
Evaluation of the Experience of Spoke Hospitals in an Academic Telestroke Network
Gadhia R, Schwamm L, Viswanathan A, Whitney C, Moreno A, Zachrison K. Evaluation of the Experience of Spoke Hospitals in an Academic Telestroke Network. Telemedicine Journal And E-Health 2018, 25: 584-590. PMID: 30256724, DOI: 10.1089/tmj.2018.0133.Peer-Reviewed Original ResearchDelays in the Air or Ground Transfer of Patients for Endovascular Thrombectomy
Regenhardt RW, Mecca AP, Flavin SA, Boulouis G, Lauer A, Zachrison KS, Boomhower J, Patel AB, Hirsch JA, Schwamm LH, Leslie-Mazwi TM. Delays in the Air or Ground Transfer of Patients for Endovascular Thrombectomy. Stroke 2018, 49: 1419-1425. PMID: 29712881, PMCID: PMC5970980, DOI: 10.1161/strokeaha.118.020618.Peer-Reviewed Original ResearchConceptsEndovascular therapySpoke hospitalsTelestroke networkUnderwent endovascular therapyEndovascular thrombectomyHealth StrokeIschemic strokeClinical outcomesMedian delayHub hospitalInclusion criteriaTelestroke consultsMultivariable regressionTreatment opportunitiesPossible predictorsTreatment ratesPatientsHospitalDaytime transfersLong transfer timesNational InstituteValidating the TeleStroke Mimic Score
Ali S, Hubert G, Switzer J, Majersik J, Backhaus R, Shepard L, Vedala K, Schwamm L. Validating the TeleStroke Mimic Score. Stroke 2018, 49: 688-692. PMID: 29374105, PMCID: PMC5829006, DOI: 10.1161/strokeaha.117.018758.Peer-Reviewed Original ResearchConceptsStroke mimicsIschemic cerebrovascular diseaseTelestroke networkTelestroke consultationCerebrovascular diseaseReceiver-operating characteristic curve analysisAcute stroke evaluationExternal validation cohortRisk prediction scoreStroke care networksCharacteristic curve analysisStroke evaluationValidation cohortClinical differencesOriginal cohortFinal diagnosisTelestroke consultsScore's abilityGeorgia Regents UniversityDiverse cohortCare networkCurve analysisCohortConfidence intervalsPrediction score
2017
Frequent Hub–Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network
Moreno A, Schwamm L, Siddiqui K, Viswanathan A, Whitney C, Rost N, Zachrison K. Frequent Hub–Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network. Telemedicine Journal And E-Health 2017, 24: 678-683. PMID: 29271703, PMCID: PMC6014912, DOI: 10.1089/tmj.2017.0252.Peer-Reviewed Original ResearchConceptsDTN timePatient presentationTelestroke consultsTelestroke networkPatient-level regression analysesAcute ischemic stroke patientsShorter DTN timesIschemic stroke patientsFrequent contactPrimary predictor variableMedian DTNTPA administrationNeedle timeTPA useSpoke hospitalsStroke patientsMore frequent contactsHub hospitalImproved outcomesMedian numberTPA deliveryPatientsHospitalRegression analysisTelestroke
2014
The TeleStroke Mimic (TM)‐Score: A Prediction Rule for Identifying Stroke Mimics Evaluated in a Telestroke Network
Ali SF, Viswanathan A, Singhal AB, Rost NS, Forducey PG, Davis LW, Schindler J, Likosky W, Schlegel S, Solenski N, Schwamm LH, Network O. The TeleStroke Mimic (TM)‐Score: A Prediction Rule for Identifying Stroke Mimics Evaluated in a Telestroke Network. Journal Of The American Heart Association 2014, 3: e000838. PMID: 24958778, PMCID: PMC4309074, DOI: 10.1161/jaha.114.000838.Peer-Reviewed Original ResearchConceptsStroke mimicsIschemic cerebrovascular diseaseTelestroke networkReceiver-operating characteristic curve analysisCurve analysisHealth Stroke ScaleVascular risk profileVascular risk factorsAcute stroke evaluationExternal validation cohortFinal clinical diagnosisLower mean ageROC curve analysisCharacteristic curve analysisStepwise logistic regressionTelestroke consultationStroke ScaleFacial weaknessConsecutive patientsDerivation cohortPrior seizuresStroke evaluationAlternate diagnosisCerebrovascular diseaseValidation cohort
2013
Separating Acute Stroke from Stroke Mimics in a TeleStroke Network: Differential Patient Characteristics and Exam Findings (P07.241)
Ali S, Cohen A, Viswanathan A, Feske S, Rost N, Silverman S, Anderson C, Schwamm L. Separating Acute Stroke from Stroke Mimics in a TeleStroke Network: Differential Patient Characteristics and Exam Findings (P07.241). Neurology 2013, 80 DOI: 10.1212/wnl.80.7_supplement.p07.241.Peer-Reviewed Original Research
2012
Telestroke increases use of acute stroke therapy
Müller-Barna P, Schwamm L, Haberl R. Telestroke increases use of acute stroke therapy. Current Opinion In Neurology 2012, 25: 5-10. PMID: 22157105, DOI: 10.1097/wco.0b013e32834d5fe4.Peer-Reviewed Original ResearchConceptsTelestroke networkStroke careUsage of guidelinesAcute stroke careAcute stroke therapyIschemic stroke patientsRate of thrombolysisNew therapeutic modalitiesStroke teamAcute strokeNeurological examinationStroke unitStroke patientsStroke therapyStroke managementImproved outcomesTherapeutic modalitiesTelestroke servicesRemote reviewUnderserved areasHigh-quality videoconferencingCareIncrease useRegular basisThrombolysis
2011
Use of Telemedicine and Other Strategies to Increase the Number of Patients That May Be Treated with Intravenous Thrombolysis
Silva G, Schwamm L. Use of Telemedicine and Other Strategies to Increase the Number of Patients That May Be Treated with Intravenous Thrombolysis. Current Neurology And Neuroscience Reports 2011, 12: 10-16. PMID: 21997715, DOI: 10.1007/s11910-011-0235-6.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeUse of telemedicineIntravenous thrombolysisIschemic strokeIntravenous tissue plasminogen activator useAdult long-term disabilityTissue plasminogen activator useLong-term disabilityAmerican Heart AssociationNumber of patientsRecruitment of patientsRate of treatmentHelp of telemedicineThrombolysis trialsHeart AssociationStroke NetworkStroke systemsTelestroke networkTelestroke systemCurrent evidencePatientsThrombolysisStrokeCareTelemedicine
2010
Stroke: working toward a prioritized world agenda
Hachinski V, Donnan G, Gorelick P, Hacke W, Cramer S, Kaste M, Fisher M, Brainin M, Buchan A, Lo E, Skolnick B, Furie K, Hankey G, Kivipelto M, Morris J, Rothwell P, Sacco R, Smith S, Wang Y, Bryer A, Ford G, Iadecola C, Martins S, Saver J, Skvortsova V, Bayley M, Bednar M, Duncan P, Enney L, Finklestein S, Jones T, Kalra L, Kleim J, Nitkin R, Teasell R, Weiller C, Desai B, Goldberg M, Heiss W, Saarelma O, Schwamm L, Shinohara Y, Trivedi B, Wahlgren N, Wong L, Hakim A, Norrving B, Prudhomme S, Bornstein N, Davis S, Goldstein L, Leys D, Tuomilehto J. Stroke: working toward a prioritized world agenda. International Journal Of Stroke 2010, 5: 238-256. PMID: 20636706, PMCID: PMC3712839, DOI: 10.1111/j.1747-4949.2010.00442.x.Peer-Reviewed Original ResearchConceptsStroke careChronic disease prevention initiativeStroke-related informationEmergency stroke careDisease prevention initiativesPublic health communication strategiesConsequences of strokeRigorous clinical researchHealth communication strategiesStroke preventionStroke centersStroke unitClinical strokeSubclinical strokeBrain recoveryCerebrovascular diseaseStroke recoveryBrain healthPoststroke rehabilitationTelestroke networkClinical careHuman studiesEpidemiological disciplinesSurrogate assessmentStrokeStroke: Working Toward a Prioritized World Agenda
Hachinski V, Donnan G, Gorelick P, Hacke W, Cramer S, Kaste M, Fisher M, Brainin M, Buchan A, Lo E, Skolnick B, Furie K, Hankey G, Kivipelto M, Morris J, Rothwell P, Sacco R, Smith S, Wang Y, Bryer A, Ford G, Iadecola C, Martins S, Saver J, Skvortsova V, Bayley M, Bednar M, Duncan P, Enney L, Finklestein S, Jones T, Kalra L, Kleim J, Nitkin R, Teasell R, Weiller C, Desai B, Goldberg M, Heiss W, Saarelma O, Schwamm L, Shinohara Y, Trivedi B, Wahlgren N, Wong L, Hakim A, Norrving B, Prudhomme S, Bornstein N, Davis S, Goldstein L, Leys D, Tuomilehto J. Stroke: Working Toward a Prioritized World Agenda. Stroke 2010, 41: 1084-1099. PMID: 20498453, PMCID: PMC3712843, DOI: 10.1161/strokeaha.110.586156.Peer-Reviewed Original ResearchConceptsStroke careChronic disease prevention initiativeStroke-related informationEmergency stroke careDisease prevention initiativesPublic health communication strategiesConsequences of strokeRigorous clinical researchHealth communication strategiesStroke preventionStroke centersStroke unitClinical strokeSubclinical strokeBrain recoveryCerebrovascular diseaseStroke recoveryBrain healthPoststroke rehabilitationTelestroke networkClinical careHuman studiesEpidemiological disciplinesSurrogate assessmentStrokeStroke: Working toward a Prioritized World Agenda
Hachinski V, Donnan G, Gorelick P, Hacke W, Cramer S, Kaste M, Fisher M, Brainin M, Buchan A, Lo E, Skolnick B, Furie K, Hankey G, Kivipelto M, Morris J, Rothwell P, Sacco R, Smith S, Wang Y, Bryer A, Ford G, Iadecola C, Martins S, Saver J, Skvortsova V, Bayley M, Bednar M, Duncan P, Enney L, Finklestein S, Jones T, Kalra L, Kleim J, Nitkin R, Teasell R, Weiller C, Desai B, Goldberg M, Heiss W, Saarelma O, Schwamm L, Shinohara Y, Trivedi B, Wahlgren N, Wong L, Hakim A, Norrving B, Prudhomme S, Bornstein N, Davis S, Goldstein L, Leys D, Tuomilehto J. Stroke: Working toward a Prioritized World Agenda. Cerebrovascular Diseases 2010, 30: 127-147. PMID: 20516682, PMCID: PMC3221270, DOI: 10.1159/000315099.Peer-Reviewed Original ResearchConceptsStroke careChronic disease prevention initiativeStroke-related informationEmergency stroke careDisease prevention initiativesPublic health communication strategiesConsequences of strokeRigorous clinical researchHealth communication strategiesStroke preventionStroke centersStroke unitClinical strokeSubclinical strokeBrain recoveryCerebrovascular diseaseStroke recoveryBrain healthPoststroke rehabilitationTelestroke networkClinical careHuman studiesEpidemiological disciplinesSurrogate assessmentStroke