Procedure to open blocked carotid arteries tested

September 27, 2013 by Lee Phillion, Washington University School of Medicine in St. Louis

Procedure to open blocked carotid arteries tested
The carotid arteries, shown above, feed blood to the brain. Doctors at Washington University are testing an investigational device designed to open blocked carotid arteries in patients whose age or poor health makes them ineligible for the traditional open surgery. Credit: SILK ROAD MEDICAL, INC.
(Medical Xpress)—Doctors at Washington University School of Medicine in St. Louis are investigating a minimally invasive procedure to open blocked carotid arteries in patients whose poor health or advanced age makes the traditional open surgery too risky.

The clinical study, taking place at Barnes-Jewish Hospital, is part of a global, multicenter trial evaluating the safety and effectiveness of a new technique and device designed for high- with disease, a condition that restricts blood flow to the brain and increases the risk of stroke.

The two carotid arteries of the neck that to the brain can become clogged with plaque in the same way that arteries in the heart can become blocked. More than 300,000 people in the United States are diagnosed with carotid artery every year. Left untreated, blockages can stop blood flow, and plaque debris can dislodge to the brain, causing a potentially disabling stroke.

The current surgical or "open" procedure used to clean out a clogged carotid artery is generally considered safe and effective but requires a large incision along the patient's neck. The procedure is usually done under and carries surgical risks that may make it unsuitable to high-risk patients.

While a less invasive alternative has been available for years, it carries a risk of stroke. Called carotid artery stenting, the procedure involves inserting a mesh stent through an artery in the groin and threading it into the carotid artery to hold the vessel open. Since the stent can knock plaque loose, a tiny umbrella-like filter is first inserted through the blocked artery to catch this debris and stop it from entering the brain. But the filter itself still carries a risk of stroke because it, too, can dislodge plaque.

"The new technique and device system may reduce the chances of these complications," said Jeffrey Jim, MD, who performs the procedure. The procedure is called transcarotid stenting with dynamic flow reversal.

"The term 'transcarotid' refers to the technique of delivering a stent directly into the carotid artery from a small incision in the neck," said Jim, an assistant professor of surgery. "It is a shorter and potentially safer route than the traditional minimally invasive method of stenting via the groin. And it can be done using local anesthetic."

The "dynamic flow reversal" part of the procedure refers to a device that temporarily reverses blood flow in the blocked artery, diverting it away from the brain and into tubing set up outside the body. Filters in this tubing remove any plaque debris knocked loose during placement of the stent. The tubing then directs the blood back into the body through a vein near the groin. Since blood enters the brain through multiple arteries, patients are not adversely affected by this temporary flow reversal in a single vessel.

"Temporarily reversing the flow ensures that the patient's brain is protected at all times," said Jim. "This procedure holds the potential to optimize treatment for our older, high-risk patients. Because it is less invasive, there likely is a lower risk of cardiac complications and patients can recover faster."

Washington University School of Medicine is one of 25 centers around the world participating in the clinical study, which is expected to enroll 140 patients.

The study is funded by Silk Road Medical, developers of the transcarotid stenting with dynamic flow reversal system.

Explore further: Cleveland Clinic study finds lowest risk treatment for severe carotid and coronary disease

Related Stories

Cleveland Clinic study finds lowest risk treatment for severe carotid and coronary disease

July 31, 2013
Of the three most common treatment approaches for patients with severe carotid and coronary artery disease, patients who underwent stenting of the carotid artery followed by open heart surgery had the best outcomes, according ...

'Risky' stroke prevention procedure may be safe in some patients

July 19, 2013
(Medical Xpress)—A major study published today in the Lancet Neurology, funded by the Medical Research Council (MRC) and the Stroke Association, found that stenting in the carotid artery (in the neck) is as safe as carotid ...

Stenting for stroke prevention becoming safer in high-risk patients

January 11, 2012
Placing a stent in a key artery in the neck is safer than ever in patients ineligible for the standard surgical treatment of carotid artery disease, according to a new study published online today in the Journal of Vascular ...

Researchers study outcomes of carotid artery stenting following prior carotid procedure

November 14, 2011
A new study shows that carotid artery stenting (CAS) following prior same-side carotid artery revascularization is safe, effective and results in lower incidences of in-hospital death, stroke and heart attack compared to ...

Fully dissolvable, temporary stent for opening heart artery blockages

September 17, 2013
The Mount Sinai Medical Center is participating in the nationwide ABSORB III clinical trial testing the performance and potential clinical benefits of a fully dissolvable and temporary drug eluting stent to open heart artery ...

Recommended for you

Genetic analysis links obesity with diabetes, coronary artery disease

November 16, 2018
A Cleveland Clinic genetic analysis has found that obesity itself, not just the adverse health effects associated with it, significantly increases the risk of Type 2 diabetes and coronary artery disease. The paper was published ...

Non-coding genetic variant could improve key vascular functions

November 15, 2018
Atherosclerotic disease, the slow and silent hardening and narrowing of the arteries, is a leading cause of mortality worldwide. It is responsible for more than 15 million deaths each year, including an estimated 610,000 ...

Study of two tribes sheds light on role of Western-influenced diet in blood pressure

November 14, 2018
A South American tribe living in near-total isolation with no Western dietary influences showed no increase in average blood pressure from age one to age 60, according to a study led by researchers at Johns Hopkins Bloomberg ...

Heart failure patients shouldn't stop meds even if condition improves: study

November 13, 2018
(HealthDay)—There's bad news for heart failure patients with dilated cardiomyopathy who'd like to stop taking their meds.

Bypass beats stents for diabetics with heart trouble: study

November 13, 2018
(HealthDay)—People with both diabetes and multiple clogged heart arteries live longer if they undergo bypass surgery rather than have their blood vessels reopened with stents, according to follow-up results from a landmark ...

New treatment significantly reduces cardiovascular events when combined with statins

November 12, 2018
Statins are the most commonly used treatment for cardiovascular disease. Despite reducing certain risk factors, if triglyceride levels remain high with use of statins, there is still a significant risk for heart attack, stroke ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.