Successful performance of the Tuscany Stroke Network: a before-and-after study

Faced with the burden of stroke, a regional strategy was implemented in Tuscany at the beginning of 2015. A hub-and-spoke model was established throughout tuscanian stroke hospitals adopting a common protocol to standardize acute ischemic stroke (AIS) care, leading to the implementation of the Tuscany Stroke Network (TSN). AIS patients are first taken to the nearest spoke hospital for possible t-PA treatment, assessed for eligibility to endovascular intervention, and quickly transferred to the nearest hub hospital, where appropriate. We investigated differences in quantity of revascularization treatments for AIS patients before and after the TSN implementation, to explore and monitor its effectiveness.