Carotid artery stenting cuts stroke risk

The new therapy, carotid artery stenting, was given limited-use approval by the U.S. Food and Drug Administration in March 2005, according to a St. John’s news release. Carotid artery stenting is considered an equally effective treatment for patients compared to carotid artery surgery, while lowering the risk for adverse outcomes in patients considered high-risk for surgery.

The standard operation, carotid endarterectomy, has been used since the 1950s to prevent stroke. It involves a surgical incision on the neck, opening the artery and peeling out blockage, then surgically closing the wound. Potential surgical complications include bleeding, wound infection, facial and vocal chord injury, and rarely, stroke or death. In patients with significant pre-existing illness such as prior heart attack with heart failure, severe lung disease or a prior neck surgery or neck radiation treatment, these surgical risks are amplified.

Stents, on the other hand, prop open the artery to restore blood flow caused by blockages. This less-invasive method allows the stent to be placed in the artery by using an X-ray machine and a catheter device. The patient is usually in the hospital less than 24 hours and has no surgical wound.

“It is safer than traditional surgery for high-risk patients” Merritt said in the news release.

Medicare and insurers recently have allowed expanded use of the stent device to include patients without symptoms of stroke who have severe blockage. St. John’s is able to offer the procedure by participating in a clinical trial that tracks patients for a year.

Candidates are people with at least an 80 percent blockage who are willing to be part of the trial and are considered high-risk for the traditional surgery.

“This is a new option for patients, especially those that may be considered too high-risk for the open surgery and therefore would be excluded from the stroke prevention benefits of carotid artery treatment,” Merritt said. “St. John’s physicians have performed 20 to 25 of the less-invasive carotid stent procedures and predict they will do another 50 to 100 over the next year.”