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Comment & Response
October 2017

Presenting to Primary Stroke Centers or Comprehensive Stroke Centers for Thrombolysis

Author Affiliations
  • 1Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio
JAMA Neurol. 2017;74(10):1269. doi:10.1001/jamaneurol.2017.2015

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

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