Author + information
- Received September 25, 2018
- Revision received January 4, 2019
- Accepted January 7, 2019
- Published online March 25, 2019.
- aDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
- bDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York
- cDepartment of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
- dJacobs Institute, Buffalo, New York
- ↵∗Address for correspondence:
Dr. L. Nelson Hopkins, Department of Neurosurgery, University at Buffalo, 100 High Street, Suite B4, Buffalo, New York 14203.
• Ischemic stroke is now treatable with catheter intervention. Revascularization must be accomplished rapidly for optimal results, but there are not enough comprehensive stroke centers or neurointerventionists to achieve this.
• Cardiologists have excellent catheter skills and extensive experience with emergency intervention, and catheterization labs are widespread, suggesting a possible solution for needed immediate intervention worldwide.
• Stroke intervention must be rapidly expanded geographically and with a dramatic increase in the number of willing and trained interventionists to meet the enormous public health need.
Stroke is a catastrophic event for patients and their families. Given the frequency of approximately 750,000 events annually with their associated morbidity and mortality, stroke has assumed increasing importance. Scientific study has identified several diseases categorized under the broad term of “stroke” that form the rationale for current treatment strategies. This paper reviews new information, especially on ischemic stroke (particularly large-vessel occlusions), which identifies the potential for new approaches that can dramatically improve outcome but will require the need to enhance and embrace the care team required to deliver optimal care and address current unmet clinical needs.
Dr. Hopkins has received grant/research support from Canon Medical Systems Corporation; has financial interests/stock in Boston Scientific, Cerebrotech, Endostream, Endomation, Silk Road, Ostial Corporation, Imperative Care, StimSox, Photolitec, ValenTx, Ellipse, Axtria, NextPlain, and Ocular; and has a board/trustee/officer position in Imperative Care Inc. Dr. Holmes has reported that he has no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received September 25, 2018.
- Revision received January 4, 2019.
- Accepted January 7, 2019.
- 2019 American College of Cardiology Foundation