Use of telemedicine and other strategies to increase the number of patients that may be treated with intravenous thrombolysis.

Stroke is the fourth leading killer in the United States and a leading cause of adult long-term disability. The American Heart Association estimates that only 3% to 5% of patients with acute ischemic stroke are treated with intravenous thrombolysis. A way to improve the rates of treatment with thrombolysis in patients with acute ischemic stroke is the creation of telemedicine stroke networks. Data from many studies support the safety of expanding intravenous tissue plasminogen activator use with the help of telemedicine. In this article we discuss the current evidence for the use of telemedicine within stroke systems of care, the importance of coordinating care within the transferring facilities in the telestroke networks, telestroke economics and applicability, and how to potentially use the telestroke systems to increase recruitment of patients into acute stroke thrombolysis trials.