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Comment & Response |

Ambulance-Based Thrombolysis in Acute Ischemic Stroke

Min Ji Kwak, MD1; Jongoh Kim, MD2
[+] Author Affiliations
1University of Texas Health Science Center, Houston
2Baylor College of Medicine, Houston, Texas
JAMA. 2014;312(9):961. doi:10.1001/jama.2014.8369.
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To the Editor Dr Ebinger and colleagues1 reported that ambulance-based thrombolysis using the Stroke Emergency Mobile (STEMO) led to higher rates of tissue plasminogen activator (tPA) treatment and shorter alarm-to-treatment time in patients with acute ischemic stroke without increasing cerebral hemorrhage or mortality rate.

Ebinger et al1 randomly assigned weeks to STEMO deployment or usual care during the study period. However, it is questionable whether the results during the STEMO weeks and the control weeks were comparable. Patients were more likely to receive tPA treatment and be transported to hospitals with a stroke unit even without STEMO deployment during the STEMO weeks than during the control weeks (24.1% vs 21.1% and 90.7% [estimated] vs 87.3%, respectively).


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September 3, 2014
Martin Ebinger, MD; Ulrike Grittner, PhD; Heinrich J. Audebert, MD
1Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany
2Center for Stroke Research Berlin, Charité–Universitätsmedizin Berlin, Berlin, Germany
JAMA. 2014;312(9):961-962. doi:10.1001/jama.2014.8378.
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