Abstract 333: Does Video Based Telestroke improve TNK and Mechanical Thrombectomy Candidate Selection

Introduction Telehealth introduced a new way to reach populations in need of healthcare without sufficient access. The concept of telestroke in particular has existed since 1999 1 . At University Hospitals Cleveland Medical Center (UH CMC), telephone telestroke was the primary method used to evaluate those with acute stroke for thrombolytic therapy, mechanical thrombectomy, and/or need for transfer until the implementation of video telestroke in January, 2025. We sought to assess how the change from telephone telestroke to video telestroke affected the frequency of TNK administration and mechanical thrombectomies performed. Methods In this retrospective study at an urban level 1 trauma and comprehensive stroke center we used our electronic medical record's (EMR) data extraction tool to assess the total number of people with the chief complaint of stroke in January 2024 through June 2024 as well as January 2025 through June 2025. We used this data to ascertain how many of these patients received Tenecteplase (TNK) or underwent mechanical thrombectomy (MT) after undergoing either telephone telehealth in 2024 versus video telehealth implemented in 2025. We then used this data to assess number of transfers to our institution. Results From January 2024 to June 2024 under the phone telestroke system, 1,627 patients were seen with a chief complaint of stroke. TNK was administered 185 times during this period and a total of 98 patients were transferred to the main campus for either consideration of MT or other higher level care needs, of whom 59 ultimately received MT. From January 2025 to June 2025 under the video telestroke system, 1,588 patients were seen with a chief complaint of stroke. TNK was administered 157 times during this period and a total of 84 patients were transferred to the main campus for either consideration of MT or other higher level care needs, of whom 58 received MT. Conclusion Preliminary data gathered within a single academic medical system found that TNK was administered slightly less frequently under a video telestroke system compared to phone. There were fewer transfers to the main campus, though MT was performed with approximately the same frequency. This could suggest improved patient selection with video‐based assessment resulting in a reduction of unnecessary transfers and improved resource utilization. Towards this end, it is possible implementation of video telestroke aids in proper MT candidate selection and thus improves treatment times for good MT candidates. Future research will involve gathering additional information to further elucidate whether video based telestroke aids in specificity and efficiency of thrombolytic and MT candidate selection. Sources : 1. L. R. Wechsler et al. Stroke (2017)