Presenting to Primary Stroke Centers or Comprehensive Stroke Centers for Thrombolysis

To the Editor The study by Gerschenfeld et al¹ attempted to address the topical question of whether patients should be brought to a primary stroke center (PSC) for early thrombolysis or be directly transported, despite a longer traveling distance, to a comprehensive stroke center (CSC) that was capable of performing a mechanical thrombectomy (ME).¹ The study found no difference in 24-hour, discharge, or 3-month outcomes between groups of those presenting to a PSC who received thrombolysis and transferred to a CSC for ME and those who presented first to CSC and received thrombolysis and ME. The study concludes “that patients treated using the drip-and-ship paradigm also benefit from bridging therapy, no statistically significant difference [in outcomes] compared with those treated directly in a CSC.”¹