More than 130,000 Americans die from a stroke each year. Stroke is the third-leading cause of death and the leading cause of long-term disability in the United States.

The chances of survival are greater when emergency treatment begins quickly, but many stroke victims don't get quick help. According to one survey, only 38 percent of people were aware of major stroke symptoms and knew to call for help.

But a new intervention method could dramatically improve survival rates by sending physicians to patients, rather than the other way around.

Studies show that only about 1 in 4 patients makes it to the hospital during a stroke within an hour of the onset of symptoms, which is the optimal time for treatment with clot-busting drugs. The drugs can be used up to 4.5 hours after the stroke symptoms first occur, but the national guidelines recommend treatment within 60 minutes on arriving at the hospital.

However, researchers examined hospital data on almost 107,000 stroke patients and discovered that this goal was met for only 18 percent of treatment-eligible patients who got to the hospital within 60 minutes after symptoms occurred.

Many times, victims don't recognize stroke symptoms quickly enough to receive timely clot-busting drugs. But often, stroke victims are transported to a nearby community hospital first and then transported to a specialized center, which further delays treatment and lowers chance of recovery.

Illustrating the significance of timely patient transport time, a recent single-patient, proof-of-concept study by a Johns Hopkins Medicine research team showed that flying a stroke specialist to a stroke patient by helicopter for care may get critical care to patients faster than transporting patients to a hospital first.

Investigators designed this study to fly Ferdinand K. Hui, M.D., by Johns Hopkins Lifeline from Baltimore to a National Institutes of Health Stroke Center at Suburban Hospital in Washington, D.C., 39.4 miles away, to treat a stroke victim. Previous logistical deliberation with hospital and medevac companies was carried out to provide the rationale and funding for helicopter transfer of a neurointerventionalist to an in-network hospital with an on-site angiographic suite.

An appropriate patient with large vessel occlusion and a National Institute Health Stroke Scale score greater than 8 was identified. Magnetic resonance imaging was performed, then the medevac transport system was activated, and the intervention was carried out.

Times were collected during the case and assessed for time efficiency. The total time from decision-to-treat to groin puncture was 43 minutes, and groin closure was completed at 77 minutes from the decision to treat.

According to Hui, infrastructure is the most limiting factor to treating stroke victims, and helistroke service is not always the best choice because of weather restrictions, specialist availability and transport costs. He points out, however, that flying specialists to patients could potentially eliminate some nursing care costs, monitoring equipment and ambulance service costs from one hospital to another as well as expanding standards of care to rural areas where specialized care is limited.