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to improve access to treatments may be inefficient. Different policies for clusters of countries could be more useful.Use of intraosseous route in thrombolysis of acute stroke patients remains a rare entity. Here, we describe the first such case within UK of a 55-year-old female patient of acute stroke who was thrombolysed with Alteplase administered through intraosseous (IO) route. She initially presented to AE with severe dysarthria dysphasia and left sided weakness with an NIHSS-8. Failing acquisition of an intravenous access a