The Prestigiacomo and Berge families have grown up and old together. For more than 35 years Chuck and Rose Marie Prestigiacomo and Mary and Paul Berge have cheered on each other's children at local swim meets, attended Badger homecoming parties and golfed together. They've gone up north on vacations together. They've attended each other's children's weddings and graduations and celebrated together the births of grandchildren.

This is the story of something else they have shared: two deadly strokes.

Unlike many other stories about strokes, it has a happy ending, thanks to rapidly evolving technology for stroke care and a gift from the Berges' that helped make that technology available to people in Madison, including, it turned out last month, their good friend Chuck.

But we are jumping ahead.

We'll go back to Oct. 13, 2003, when Mary Berge started acting confused during the day and then collapsed on her bedroom floor before dinner. Her husband recalls it seemed to take the ambulance forever to reach their home in Nakoma and get them to St. Mary's Hospital. The ambulance didn't even turn on its siren. "We rode in a very leisurely way as if we were just going out for pizza," Paul recalls. It wasn't until the next morning that Mary was seen by a neurologist and given an MRI exam, which revealed that a blood clot was preventing the flow of oxygen and blood to her brain. She had had a stroke. It was too late to do much about it. Only until very recently has there been any effective treatment for strokes and awareness of the need to rush patients to hospitals to get it.

Mary needed three weeks of hospitalization and months of rehabilitation before she got back on her feet. She now uses a cane and says she still suffers memory and speech lapses.

Strokes are the third leading cause of death in this country and the number one cause of long-term disability. About 795,000 Americans suffered a stroke last year. In Wisconsin, about 15,000 people suffer a stroke every year. More than 2,500 die, and thousands more end up with permanent brain damage and paralysis.

Mary's experience made the Berges determined to do what they could to improve this grim situation in the Madison area. Paul is the former chairman and chief executive officer of M&I bank, and the couple made a large donation that helped St. Mary's open the area's first certified stroke center in 2007. Both UW Hospital and Meriter have since followed suit.

These three certified stroke centers have ushered in a revolution in how strokes are handled in the Madison area. Now a drug called tPA can often dissolve the clots, if given in time, and exciting new mechanical tools can be threaded through the body's highway system of veins and arteries directly to the brain, where they can pluck, squeeze, tug and vacuum out the deadly clots that cause strokes.

On Oct. 14 of this year, exactly six years and one day to the date Mary had her stroke, it was the Prestigiacomos' turn. Thanks to this new technology, their experience was dramatically different.

They had gone out for breakfast, a favorite pastime now that both are retired from their days of owning and operating a couple of local grocery and liquor stores. Chuck, 79, remembers the meal tab - $8.10. He also remembers feeling suddenly faint. For the rest of the day, he had a bad headache. At around 11:30 that night he went to bed. "Between the time I'm going down and my head hit the pillow I just felt like I was drowning," he says. "And I thought, goddamn it, I'm not going to make 80."

He started hiccuping. "I got mad and said 'For crying out loud, be quiet! I'm trying to sleep,' " Rose Marie recalls. She turned the light on. "He was lying there and his mouth was all twisted," she says. "He couldn't talk." She called 9-1-1.

An ambulance arrived "within minutes," Rose Marie recalls, and rushed them to the hospital, where a neurologist was waiting. Immediately, Chuck was given a bunch of tests and scans that took pictures of his brain.

Dr. Rick Baker, an interventional radiologist and the medical director of St. Mary's Imaging Department, got a call around 1:30 that morning from the neurologist. "We got a positive case in the ER," he said. Baker switched on his home computer and looked at the scans. Sure enough, the patient was having a stroke. There was a large thrombus, or clot, in Chuck Prestigiacomo's basilar artery at the base of his brain. This particular kind of stroke is especially deadly: in the past, nine out of 10 patients have died.

But this particular kind of stroke is also a good candidate for a promising new device the hospital had been waiting to use called the Merci Retrieval System, cleared by the FDA in 2004. The tool, which costs between $6,000 and $8,000, has been used on nearly 10,000 patients in 500 hospitals around the world, and according to trials was successful in more than half of those cases, compared to just a small number of patients who recovered without it. The Merci retriever is a tiny, corkscrew-shaped wire that is inserted into an artery in the groin, and then threaded through vessels up into the brain, where it wraps around the clot and traps it.

Baker rushed to the hospital. He had practiced on a dummy, but this would be the first time he would use the device on a patient.

First, though, Baker tried spraying the clot with the drug tPA. It did little good. Chuck's speech was still slurred, his left side still "floppy," recalls his wife. Baker decided that Chuck's best and only hope was to go ahead with the Merci retriever.

Surgery started close to dawn. Chuck was conscious but sedated, his head taped to the operating table so he didn't fidget or move.

Before the procedure, his eyes teared up. "I'm not ready to go yet," he told Baker.

"We're going to do the best we can," Baker promised him.

It was a tough case because Chuck's arteries are what doctors call "tortuous," very narrow and twisted. Normally, Baker says, it takes maybe five minutes to thread a tool through a catheter up to the brain. That night it took half an hour.

And once they got to the clot, they had to grasp and remove it without pushing it further into the brain or losing it in the bloodstream, where it could cause further damage. "Go slow," warned the lead angiotechnologist, Guy Williams. Baker asked the nurse, Shelly Borgess, to put on a timer so he would be sure to take at least the recommended seven minutes to remove the clot. "If you do it too fast, it slips out," he explains.

There at the end of the tiny tool was the villain: a stringy, red clot a few milliliters long.

"We got it!" Baker said.

Almost immediately, Chuck's speech improved. A week later, he was home again. Today, a few weeks later, he is pretty much back to himself. He and his wife are even back to cooking together.

"It's a miracle," Rose Marie says.

Their friends are thrilled, too.

"Life came full circle for us, in a very good way," says Paul Berge. Agrees his wife, Mary, "We're so happy we could do something to help the next person who comes along, and that that person happens to be our good friend."

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