The first experience of tele-primary vascular department to provide assistance to patients with ischemic stroke in the Krasnoyarsk territory

Abstract

Introduction. Over 2023, in vascular centers of the Krasnoyarsk Territory thrombolysis operations were performed in five hundred ninety six cases with ischemic stroke, which amounted to 7.7% of all admitted patients and corresponds to the recommended federal indices. Nevertheless, due to the length and sparsely populated territory, there remains a part of patients who live in territories remote from the PVD and Regional Vascular Centers (RVC), when the transport leg significantly exceeds the “therapeutic window”, and therefore reperfusion therapy becomes impossible for them. The solution to this problem was the management of tele-PVD in a number of territories of the Russian Federation on the basis of district hospitals with the availability of Multispiral Computer Tomography (MSCT) in the Krasnoyarsk Territory. Results. The first results of performing 20 thrombolysis in the tele-PVD showed the effectiveness and safety of the technique. Hemorrhagic transformations according to the control MSCT were no observed. There were no fatal outcomes among the patients who underwent thrombolytic therapy (TLT). Regression of neurological deficit occurred in 55% of cases, 75% of patients were discharged in Rankin 1–2 state. The results of thrombolytic therapy correspond to the indices of regional and urban vascular centers. Conclusion. Performing thrombolytic therapy in tele-PVD under the telemedicine supervision of RVC specialists is a safe and effective procedure and allows increasing the number of reperfusion interventions in patients with ischemic stroke.