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In the more than 20 years since intravenous tissue plasminogen activator (IV TPA) was shown to improve outcomes for acute ischemic stroke, the process for implementing and disseminating this therapy into widespread clinical practice has continued with deliberate effort. Increasing public awareness about stroke symptoms and improving the prehospital stroke response can create additional opportunities to treat stroke with IV TPA, but if an otherwise-eligible patient arrives within 2 hours after symptom onset, the responsibility for actually realizing these opportunities rests squarely with each receiving hospital.
Now, researchers report that the percentage of otherwise-eligible patients arriving within 2 hours of symptom onset that failed to …