Kass-Hout T, Lee J, Tataris K, et al. - A significant, rapid, and sustained increase in endovascular therapy (EVT) rate for patients with acute ischemic stroke (AIS) was associated with the implementation of a prehospital transport policy for comprehensive stroke center triage in Chicago, with no negative associations with thrombolysis rates or times.

• Among 7,709 stroke patients, 663 (mean [SD] age, 68.5 [14.9] years; 342 women [51.6%] and 321 men [48.4%]; and 348 Black people [52.5%]) with AIS arrived by emergency medical services (EMS) transport within 6 hours of stroke onset: 310 of 2,603 (11.9%) before implementation and 353 of 2,637 (13.4%) after implementation.

• The EVT rate increased overall among all AIS patients and among AIS patients transported by EMS within 6 hours of onset.

• According to an interrupted time series analysis of EMS-transported patients, the level change within one month of implementation was 7.15% with no slope change before or after, indicating a step rather than gradual change.

• There was no change in the time to thrombolysis or the rate of thrombolysis.

• There were no variations in EVT rates in patients not arriving by EMS in the 6- to 24-hour window or by interhospital transfer or walk-in, regardless of time window.