In this cohort study, when the PSC protocol was fully executed, the rate of good outcomes was doubled and the time from arrival at the PSC to reperfusion at the CSC was almost 1 hour less than that with only a partial execution of the protocol. When fully implemented, a standardized protocol at PSCs for patients with suspected ELVO consisting of early CSC notification, computed tomographic angiography on arrival to the PSC, and cloud-based image sharing is associated with a reduction in time to groin puncture and improved outcomes.

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