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(Circulation. 2007;115:2602-2605.)
© 2007 American Heart Association, Inc.

Editorial

Recanalization and Stroke Outcome

Gregory J. del Zoppo, MD; James A. Koziol, PhD

From the Department of Molecular and Experimental Medicine (G.J.d.Z., J.A.K.) and Division of Biomathematics (J.A.K.), The Scripps Research Institute, La Jolla, Calif.

Correspondence to Gregory J. del Zoppo, MD, Department of Molecular and Experimental Medicine, The Scripps Research Institute, 10550 N Torrey Pines Rd, MEM-132, La Jolla, CA 92037. E-mail grgdlzop@scripps.edu

Key Words: Editorials • angiography • cerebrovascular circulation • reperfusion • stroke • ultrasonics

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Since work in the early 1980s suggested that acute recanalization of an occluded brain-supplying artery was feasible, a series of small uncontrolled and controlled studies supported the notion that recanalization could improve the outcome of ischemic stroke.¹ That early work paralleled similar successful efforts to achieve recanalization of occluded coronary arteries with plasminogen activators in patients presenting acutely with myocardial ischemia. The very nature of the outcomes of ischemic cerebrovascular disease, that demise does not reflect the evolution of brain injury, different from myocardial ischemia, has required rapid, readily applicable reproducible assessments that include neurological deficits and types and grades of disability. These reflect the arterial supply of the brain and its regional specialization of function: motor skills, sensory perception, speech, association areas (mostly silent), cognition, autonomic function, and countless others. This complexity of functions vulnerable to focal ischemia, the variations in arterial supply from patient to patient, and differences in occlusion location within a single brain-supplying artery ensure that outcomes can be quite heterogeneous. From the outset, it has been recognized that instruments for outcome measures must capture these variables. To date, the most versatile instruments reflect functions that can be readily detected by the neurological examination. But, obtaining information regarding arterial supply and occlusion location together in the acute setting requires formal imaging techniques. This information cannot be exactly deduced by the neurological examination alone.

Article p 2660

	Recanalization of Cerebral Arteries Improves Outcome

 
The hypothesis that recanalization of an occluding thrombus in the symptom-producing cerebral artery could improve neurological function (reduce disability) became . . . [Full Text of this Article]

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Issue Highlights
Circulation 2007 115: 2591. [Extract] [Full Text]