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4/28/2005
Mobile, AL - Frank T. Bunch, M.D., a cardiologist with Cardiology Associates, is performing a breakthrough, non-surgical procedure on carotid arteries in the neck that may reduce risk of suffering a stroke.
Carotid arteries are arteries in the neck that supply blood to the brain. Classically, if you had blockage in your carotid arteries, it could lead to stroke, so you would undergo surgery under general anesthesia to open up the arteries.
Now with this new procedure, instead of surgery, a person can undergo carotid stenting. Carotid stenting has been around for awhile now, but recently, in January of 2005, the FDA approved a new stent from Guidant that has distal embolic protection. The new stent includes an umbrella type filter which allows blood flow, but catches particles which are larger than the size of red blood cells which may cause stroke.
Carotid artery stenting is done in a very similar fashion as performing stenting of the coronary vessels of the heart. When performing carotid artery stenting, the distal embolic umbrella device is placed past the blockage and opened. Similar to the coronary angioplasty, a balloon is used to open the vessel and a stent is placed. After the stent is placed, any debris which may have been “knocked loose” during the procedure is caught in the umbrella. After the procedure is completed from the stenting and the vessel standpoint, the umbrella device is then retrieved in a fashion that the debris remains within the umbrella and is brought outside the body. The patient is heavily sedated but awake throughout the relatively painless procedure.
The first major study was the Sapphire study performed through Cordis Corporation in which patients who were non-surgical candidates underwent carotid artery stenting using the distal embolic protection device. At 30 days following the procedure, the carotid artery stent patients, which were high risk patients, were 50% less likely than the surgical endarterectomy patients to have suffered stroke, heart attack or death. The overall rate of complication for the carotid artery stent patient was 5.8% compared to 12.8% in the carotid endarterectomy group. Following this same group of patients over a two year period shows that, at two years out, the blockage reformation rate has been approximately 6.1% for the carotid endarterectomy patients and 1.4% in the stent patients. This very successful major study, in conjunction with a similar study provided by Guidant Corporation, has led to the FDA approval of the first distal embolic protection device used in carotid stenting. This device is initially being approved for high risk patients and currently there is a large study on asymptomatic patients which we expect to show similar success rates and should broaden the indications for carotid artery stenting.
Carotid stenting should be done by a highly trained and experienced physician. The procedure is currently only being performed at two area hospitals – Thomas Hospital in Fairhope and Springhill Medical Center in Mobile. Dr. Bunch is the only physician from Birmingham to Pensacola performing approved distal carotid artery stenting in this area, although physicians are doing it not using the distal protection. Dr. Bunch is the only physician who is a Proctor teaching carotid artery stenting to other physicians for both Cordis and Guidant. Dr. Bunch has been involved in research since 1992-94 and did two protocols in Mobile/Baldwin counties in 1998-99.
Cardiology Associates is a 25-physician group providing coordinated and integrated comprehensive heart services including pediatric cardiology, adult clinical, invasive and interventional cardiology, preventive cardiology, electrophysiology and the treatment of heart failure, peripheral vascular disease, cholesterol and lipid disorders. Cardiology Associates is committed to improving access to cardiovascular care, decreasing mortality due to heart disease and enhancing the quali
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