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4/15/2002
Placing stents in the carotid artery, which supplies blood to the brain has long been considered a risky procedure due to the risk of a stroke occurring during the treatment, but a new safety device called the angioguard now protects the brain during stent placement, acting as a filter that catches any dislodged plaque that could travel to the brain possibly causing a stroke.
The device functions like an umbrella. Once inside the artery the angioguard device opens into a basket to catch debris, while at the same time allowing blood to flow, and then closes down again to be removed from the artery, taking with it the dangerous, stroke causing plaques that have concerned cardiologists, cardiac surgeons and neurologists for years.
The only location along the northern Gulf Coast that this new procedure is currently being performed is at Springhill Medical Center by cardiologist Frank T. Bunch, M.D. of Cardiology Associates. These procedures are part of a clinical research trial currently underway with the FDA. According to Dr. Bunch, the success rate is astounding. To date, more than 2,000 endovascular carotid stent procedures have been performed worldwide with a technical success rate of 98.6%. Dr. Bunch comments that, “The opportunity to provide patients with this new technology that decreases discomfort as well as morbidity is one of the most exciting advances in cardiovascular care in our area.”
Stroke is the third largest cause of death in America today and the leading cause of long-term disability. The same type of plaque that builds up in the coronary arteries, causing a heart attack can also build up in the carotid arteries causing a debilitating or life threatening stroke. In the past, the only possible treatment was a surgical procedure called endarterectomy. Endarterectomy is performed by vascular surgeons and requires general anesthesia, a 4 inch incision in the neck, a 2-3 day hospital stay and the opening, scraping and re-stitching of the blood vessel.
The “carotid stenting with angioguard” procedure requires a catheter to be inserted into the groin and then advanced until it reaches the blockage in the carotid artery. The angioguard is opened like an umbrella, creating a filter between the brain and the area being treated, throughout the procedure. The physician uses a balloon catheter to compress the built up plaque against the wall of the artery. A small metal tube called a stent is then placed in the artery. The stent helps hold the artery open and keeps the material compressed against the wall of the artery after them procedure. The angioguard basket catches any debris that may be dislodged during the treatment, at the same time allowing blood to flow. Once the procedure is completed, the device is closed, again like an umbrella, and is removed when the catheter is pulled out.
Carotid stenting takes approximately 45 minutes, requires no general anesthesia and a hospital stay of less than 24 hours. Prior to and following the procedure the cardiologist consults with a team of specialists to include a vascular surgeon, a pathologist and a neurologist. These specialists provide, to the cardiologist, expertise in their respective fields. “This special device has been very promising for decreasing a potential risk associated with the procedure,” said Springhill Medical Center President, Bill Mason. “We applaud Dr. Bunch and continue to encourage this type of work to advance the unmatched quality health care upon which Springhill Medical Center was founded.”
People with a carotid blockage may or may not experience symptoms. Many carotid blockages are discovered by primary care physicians during a routine exam by listening to the patient’s neck with a stethoscope.
Symptoms May Include:
• Sudden weakness in an arm, hand or leg
• Loss of feeling on one side of face or body
• Loss of sight out of one eye
• Difficulty talking
• Inability to understand what someone is saying
• D
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