Abstract
Background and Purpose: Intravenous recombinant tissue plasminogen activator (rt-PA) is underused, particularly in remote areas such as isolated islands. National rates of rt-PA usage among eligible patients remain <5%. Our purpose is to evaluate the possibility of “drip-and-ship” method of rt-PA by helicopter transportation for acute ischemic stroke patients in the isolated islands of the Nagasaki prefecture.Methods: We reviewed the cases of acute ischemic stroke in this region from January 2007 to June 2011, who were transferred to our institution by helicopter after consultation via teleradiology.Results: Four cases had rt-PA infusion started at a remote hospital in the isolated islands, and then they were transferred to our institution by helicopter. In 2 of the cases, recanalization of occluded vessels was demonstrated and their clinical symptoms improved. There were no hemorrhagic complications.Conclusion: For management in the isolated islands, a remote teleradiology system is indispensable to decide whether there are indications for rt-PA. Utilization of a helicopter transportation system is a very useful and safe way to deliver the therapies as needed. “Drip-and-ship” method of rt-PA by helicopter transportation may be a safe, effective, and ideal in remote areas such as isolated islands although we need a further collection of cases.
