Weill Medical College of Cornell University

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Acute Stroke Revascularization

Stroke is one of the leading causes of disability and the third leading cause of death in the United States. There are 750.00 strokes annually. Approximately 80% of all strokes are due to the blockage of a brain artery and are called ischemic. 20% of strokes are due to the rupture of a blood vessel in the brain and are called hemorrhagic. This addresses ischemic stroke.

Stroke must be suspected if one or several of these signs appears suddenly – weakness or numbness on one side of the body, deviation of the mouth on one side, inability to speak or to understand when spoken to, sudden loss of vision on one side, trouble with walking and dizziness, loss of balance, sudden intense and unusual headache. If one of these signs is present, the patient should immediately call 9-1-1. Even if the symptom disappears, the patient should still call 9-1-1; this temporary event is called a TIA (transient ischemic attack) and there is a risk of having a permanent stroke.

Ischemic stroke can be treated with t-PA, a clot-dissolving medicine, when it is given less than 3 hours after symptom onset. However, because stroke is painless, most patients do not arrive in the hospital in time for this treatment.

Other treatments aimed at removing the blockage in the brain vessel mechanically are available until 8 hours after symptoms onset. One of these is the MERCI Retriever, devised by Pierre Gobin, MD, a device that removes the embolus blocking the brain artery. Another is the Penumbra system that macerates (mashes) and sucks out the embolus. In acute stroke revascularization, a tiny microcatheter is inserted into a lower limb blood vessel and brought to the area of occlusion in the brain artery. There the MERCI or Penumbra system is used to reopen the artery.

Weill Cornell is one of the leading institutions in the clinical practice of acute stroke revascularization, a relatively new treatment for this condition. Our multidisciplinary stroke team is comprised of Endovascular neurosurgeons Neurosurgeons Stroke neurologists Neurointensivists Additionally, the Weill Cornell Stroke team participates in several novel research protocols testing procedures for improvement of outcome in patients with acute stroke.