The Stroke Program at Weill Cornell Medicine Neurological Surgery is a leader in the treatment and prevention of stroke. Our multidisciplinary stroke team is comprised of endovascular neurosurgeons, interventional radiologists, stroke neurologists, and neurointensivists. Our neurosurgeons are internationally recognized experts in cerebrovascular conditions and have advanced training in the very latest minimally invasive procedures used to treat and prevent stroke.
Treatments for Stroke
Stroke is one of the leading causes of disability and the third leading cause of death in the United States, with 750,000 strokes a year. Approximately 80 percent of all strokes are ischemic strokes, caused by the blockage of a brain artery. A mild ischemic stroke can be treated with intravenous administration of t-PA, a clot-dissolving medicine, when it is given less than four and a half hours after symptom onset — but many patients do not arrive in the hospital in time for this treatment. The medicine is also less effective against moderate and severe strokes.
An advanced alternative is a minimally invasive surgical treatment called mechanical embolectomy, which is designed to remove the blockage in the blood vessel. In mechanical embolectomy, a surgeon inserts a microcatheter (a small plastic tube) into the artery in the patient’s upper leg and threads it (under X-ray guidance) into the blocked artery of the brain. The surgeon then slips a device inside the plastic tube and advances it to the site of the clot to aspirate (remove) the clot.
There are several devices that may be used for a mechanical embolectomy: the Penumbra device works by macerating the blockage (basically chewing it up into pieces) and then removing the pieces. Stentrievers (such as the Solitaire and the Trevo) are designed to remove the blood clot as a whole.
Mechanical embolectomy devices do not use t-PA and can be used many hours after the onset of stroke symptoms (up to eight, sometimes even 12 hours). Stroke treatment is always an emergency, however, as each passing hour reduces the benefits of treatment while increasing its risks.
Pioneers in Stroke Treatment
The Weill Cornell Medicine INR (Interventional Neuroradiology) team is highly experienced in endovascular stroke treatment, having developed the first-ever mechanical embolectomy device (MERCI retriever) 15 years ago and having initiated or participated in most of the major clinical trials on treatment of acute ischemic stroke.
Our surgeons have additional expertise in cerebral neovascularization, also called bypass surgery, which is used to address “cerebrovascular insufficiency,” or a reduction in oxygen to the brain due to a blocked or narrowed carotid artery. Cerebrovascular insufficiency can lead to a stroke or a transient ischemic attack (TIA or "mini-stroke"). Cerebral neovascularization surgery provides new blood supply that can help prevent strokes and TIAs.
In addition to our clinical expertise, the Weill Cornell Medicine stroke team also participates in several novel research protocols testing procedures for improvement of outcome in patients with acute stroke. Our combination of compassionate patient care, advanced capabilities in the operating room, and research into treatments of the future make us uniquely qualified to treat and prevent stroke.
For more information about the Stroke Program, contact the office of Dr. Philip Stieg at 212-746-4684 or use our online form to request an appointment.