Expanded modes of tissue plasminogen activator delivery in a comprehensive stroke center increases regional acute stroke interventions.

BACKGROUND AND PURPOSE: We sought to evaluate whether a comprehensive stroke center could work with regional hospitals to increase the use of tissue plasminogen activator (tPA) in acute stroke. METHODS: In 30 months, 142 patients seen at the Mid America Brain and Stroke Institute received tPA. Site of presentation, protocol selection, and outcomes were analyzed. RESULTS: We found that 18.2% (142 of 781) of all ischemic strokes received tPA. Of those, 70% (99 of 142) were transferred from hospitals within 100 miles of Kansas City (Mo). Mortality rate was 12.7% (18 of 142). Symptomatic hemorrhage rate was 9.2%. CONCLUSIONS: A comprehensive stroke center can serve as a hub for a regional network and increase the number of stroke interventions with acceptable outcomes.