An ischemic stroke occurs when a vital blood vessel that supplies oxygen to the brain becomes blocked or "clogged" and reduces blood flow to part of the brain. Within minutes, brain cells and tissues begin to die from lack of oxygen and nutrients. Most strokes (85 percent) fall into this category. Our team uses advanced imaging procedures and electrodiagnostic testing to visualize brain function and anatomy to make an accurate diagnosis of ischemic stroke and to pinpoint the location of the clot. Tissue plasminogen activator (tPA) is the first treatment for people with ischemic stroke. This clot-dissolving medicine is effective when given within four-and-a-half hours of the onset of stroke symptoms in patients who do not have bleeding in the brain. Other medications may also be given to protect brain tissue.
For patients whose clots do not resolve with tPA or for whom tPA is no longer a treatment option, our doctors may use surgical procedures to mechanically remove a blockage in the brain vessel and restore blood flow (an approach called "mechanical revascularization"). Doctors insert a tiny catheter into a lower limb blood vessel and guide it to the blockage in the brain artery. They then use one of several mechanical devices to remove the clot by extraction or suction. Small doses of clot-busting medications can also be delivered through the microcatheter. NewYork-Presbyterian/Weill Cornell interventional neuroradiologist Pierre Gobin, MD, was part of the team that invented the MERCI Retriever, the first device created to remove blood clots in the brain. That advance led to the development and use today of even more effective devices.
Patients who have survived and recovered from a stroke are at high risk for recurrence. At NewYork-Presbyterian/Weill Cornell, our cerebrovascular specialists employ treatments designed to reduce the risk of a second stroke. These treatments include medical therapies such as blood thinners, statins, and blood pressure medications, as well as surgical procedures to enhance blood flow to the brain.Related Treatments