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Leading the way in stroke care for Veterans at the Minneapolis VA Health Care System

photo of a patient laying in a hospital bed facing away from the viewer. They are looking at a screen with a doctor's face. A technician is beside the patients bed looking at the screen.
Life-changing developments in healthcare technology have reshaped the management of acute strokes. TeleStroke care brings a vascular trained neurologist to the bedside of any patient within ten minutes.

Minneapolis VA is leading the way in stroke care for Veterans. It is the first Veteran’s hospital to provide state-of-the-art stroke care on two major fronts: 1.) Stroke reversing using the clot busting medication Tenecteplase and 2.) Providing TeleStroke care via the VA National TeleStroke Program.

Tenecteplase (TNK)

Clinical data and research show TNK to be as effective, if not better than, the standard clot-busting drug Alteplase. Minneapolis VA medical center (VAMC) switched to using TNK in August 2022.

While stroke guideline updates can take years, clinical evidence evolves and grows at a faster rate. Clinical evidence shows that TNK is effective in reversing acute strokes and it is more cost-effective, faster, and easier to administer to patients. A single dose of TNK takes five seconds to administer, unlike Alteplase which involves an hour-long infusion.

Faster delivery time of the full dose of TNK increases the chances of a better outcome for patients. If a patient requires transfer out for further care, such as a mechanical removal of the clot, the paramedics will have an easier time.

"Although one in four stroke survivors will have another stroke, the good news is that strokes are preventable and treatable," says Sheetal R Patel, MD, neurologist, Minneapolis VA Health Care System, Stroke Committee Co-Chair, affiliate faculty at the University of Minnesota. "Initial response time matters in getting a good outcome at the time of the stroke, as second chances are very hard to come by."

Prompt diagnosis and treatment improves the chance of a fast delivery of clot-dissolving therapy like TNK. This reduces stroke-related disability and increases the possibility of living independently. The TNK administration must happen through an IV within four and a half hours after a stroke. Post-TNK, patients receive high quality care and monitoring in the Minneapolis VA intensive care unit for at least for 24 hours.

Be stroke smart, BEFAST

Seek immediate medical attention if you notice new problems with:

  • Balance
  • Vision in one or both eyes
  • Face droop
  • Weakness in arms
  • Slurred or strange speech

Think “BEFAST” when you suspect stroke symptoms: Balance, Eyes, Face, Arm, Speech and Time (act fast to call 911).

TeleStroke

In June 2023, Minneapolis VA joined the VA National TeleStroke Program (NTSP). The Minneapolis VA medical center is the 65th hospital in the program, but the first location to use TNK in combination with TeleStroke care.

TeleStroke speeds up access to care by connecting neurologists at a remote site to a patient's bedside via an iPad. Connection happens within 10 minutes of symptom detection, 24/7/365. A neurologist can view brain imaging in real time, review the chart and labs, and make treatment decisions with the patient and local providers, as a team.

TeleStroke is the future of stroke care when every minute matters in preventing permanent disability. The NTSP mission is to ensure that Veterans receive prompt diagnosis and standardized treatment, whether the patient is at a large or small VA hospital. The program began in September 2017. Since that time, it has grown to serve over 60 VA hospitals across the nation.

A stroke is a medical emergency. In a stroke, brain cells begin to die due to lack of oxygen from disrupted normal blood flow. Early action helps to prevent brain damage and permanent disability. A patient’s quality of life and even survival may be determined in the first few hours after a stroke.

If a patient is outside of the typical 4.5-hour window for receiving IV thrombolytic treatment, they may still benefit from other therapies. Identification of patients within this extended time window requires a neurologist's clinical expertise. “By adding TeleStroke as part of our stroke service for Veterans, we ensure the highest quality of care for every Veteran during every visit,” says Kevin Brown, DO, MBA, Chief of Neurology, Minneapolis VA Health Care System, Stroke Committee Co-Chair.

Minneapolis VA Medical Center is a VA-recognized Primary Stroke Center. Learn more about the care we provide.

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