ABSTRACT NUMBER: ESOC2026A230 BREAKING NEW GROUND: THE PHILIPPINES’ FIRST LGU-BASED TELESTROKE NETWORK FOR THROMBOLYSIS — EXPERIENCE AND CASE REPORT

Abstract Background and aims Stroke remains a primary cause of morbidity and mortality in the Philippines, where urgent access to reperfusion therapy is frequently hindered by traffic congestion, delayed recognition, and limited specialist availability. These challenges persist even in highly urbanized areas such as Quezon City (QC). To streamline triage and accelerate referral, East Avenue Medical Center (EAMC), in partnership with the QC local government unit (LGU), established the first LGU-anchored telestroke network in the country. This abstract reports the first two thrombolysis cases successfully managed under this system, demonstrating feasibility, safety, and early clinical benefit. Methods The network links QC first responders directly with EAMC neurologists through real-time voice and video communication. Using the EAMC Stroke Model, neurologists perform remote history-taking and focused neurological assessment to quickly identify candidates for thrombolysis. Patients are then transported to EAMC via free Barangay ambulance services, allowing prioritized movement and reduced delays related to urban traffic. Neuroimaging and final thrombolysis decisions are completed on arrival at EAMC. This report, formatted according to CARE guidelines, details patient presentation, referral intervals, treatment implementation, and clinical outcomes. Results Two patients—a 48-year-old male and a 66-year-old female—were evaluated remotely and transported within 32–68 minutes from last known well. Both received alteplase (0.9 mg/kg) with door-to-needle times of 58 and 59 minutes. Favorable outcomes were achieved, with discharge modified Rankin Scale scores of 1 and 0. Conclusions These first thrombolysis cases confirm the network’s feasibility in low-resource settings and suggest strong potential for scalable stroke care improvement. Conflict of interest Gerard Vincent Aguas: Nothing to disclose Figure 1 - belongs to Methods Figure 2 - belongs to Results