Background and Aims: Prehospital delay is one of the major causes of low rate of intravenous rt-PA thrombolysis for acute ischemic stroke in China. Regional emergency systems have been proved a successful approach to improve access to thrombolysis. To improve rapid access to rt-PA thrombolysis in Shenzhen,  Shenzhen stroke emergency map, the first city  stroke emergency map,  was implemented by Shenzhen healthcare administrations. 
Methods: This map comprised certification of qualified local hospitals, identification of stroke patients, acute stroke transport protocol and maintenance of the map. We conducted a retrospective observational study to compare consecutive patients with acute stroke arriving qualified local hospitals before and after implementation of Shenzhen stroke emergency map.
Results: After implementation of map, the rate of patients receiving rt-PA thrombolysis increased from 8.3% to 9.7%(P=0.003), and the rate of patients treated with endovascular thrombectomy increase from 0.9% to 1.6%(P＜0.001). Sixteen hospitals (16/20) have an increase in the number of stroke patients treated with rt-PA thrombolysis. The median time between the receipt of the call and the arrival on the scenereduced significantly (17.0 minutes vs 9.0 minutes, P＜0.001). In Shenzhen Second People’s Hospital, the median onset-to-needle time and door-to-needle time was reduced ( 175.5 min vs 149.5 min, P=0.039; 71.5 min vs 51.5min, P＜0.001 ). Currently, there are more than 40 cities implementing stroke emergency map in China. 
Conclusions: The Shenzhen stroke emergency map improves access to rt-PA thrombolysis for acute ischemic stroke, and the novel mode has been expanded to multiple areas in China. Future efforts should be conducted to optimize stroke emergency map.

CITY STROKE EMERGENCY MAP IMPROVES ACCESS TO RT-PA FOR PATIENTS WITH ACUTE ISCHEMIC STROKE