RESEARCH
ARIZONA HEART INSTITUTE

 

Carotid Stent Angioplasty: New Hope For Stroke Prevention

Historically, the treatments for obstructive carotid artery disease have been a surgical procedure called carotid endarterectomy or medical management (medication, diet and lifestyle changes). Endarterectomy has become the preferred treatment as this procedure has proven to drastically reduce stroke rates over medical management alone.

However, endarterectomy has many limitations, particularly in patients with other medical conditions. The surgical procedure usually requires general anesthesia, is limited in its applications, and can result in cranial nerve palsies.

An alternative to endarterectomy called carotid-stent supported angioplasty is now offered through research studies being conducted by the Arizona Heart Institute.

Stroke occurs when a vessel that carries blood to the brain becomes blocked, preventing oxygen-rich blood from reaching the brain. Often, the blockage that causes stroke occurs in the carotid arteries, which run through both sides of the neck and supply blood to the head and brain.

The carotid stent procedure utilizes a small metal scaffold-like device that is inserted in the blocked carotid artery via a routine catheterization. Compared to an endarterectomy, the stent procedure is less invasive.

The Arizona Heart Institute is using an additional procedure to make carotid stenting even safer. This involves using a protection device designed to prevent cerebral embolisms, pieces of the blockage, from dislodging and traveling to the brain, which can cause death. The device is inserted in the carotid artery above the blocked area and deployed like a tiny umbrella so it catches any embolisms that may break away from the original clot. The protection device and any debris it traps are then removed from the artery after the stent is in place.

For more information about carotid stenting, call the Public Relations Department at (602) 240-5854.

What is the purpose of carotid stenting?
Past research has not consistently examined the long-term effectiveness of both endarterectomy and the use of a carotid stenting system. Our studies also are examining the effectiveness of using a protection device with the stenting procedure. This research will help determine if the protection devices will decrease the likelihood of the occurrence of a stroke after the stenting procedure.

What is involved with the treatment?
Patients will receive treatment with either an endarterectomy or a carotid stenting system. Patients are required to return to the Arizona Heart Institute for follow-up evaluations at 1 month post-procedure, 6 months post-procedure, 12 months post-procedure, 24 months post-procedure for five years; 36 months post-procedure, and 48 months post-procedure and 60 months post-procedure. Patients must also be willing to have a neurological exam at each of the follow-up visits.

Who is a candidate for carotid stenting?
A complete screening and evaluation of a candidate's medical history is necessary to determine eligibility for the study. We evaluate potential candidates based on the following general criteria:
  • Patients who are symptomatic with a blockage of 50 percent or greater in at least one carotid artery
  • Patients who are asymptomatic with a blockage of 80 percent or greater in at least one carotid artery.

    For more information, call the Arizona Heart Institute Interventional Research Department at (602) 266-2200 ext. 4677.



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    The information presented in this site should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other healthcare provider.