CAROTID ARTERY STENTING OFFERED BY PHYSICIANS AT SAINT JOSEPH'S HOSPITAL

Dr. Tim Swan

Physicians at Saint Joseph's Hospital are offering a new, less invasive treatment option to prevent the risk of stroke in patients with carotid artery disease. The therapy, called carotid artery stenting, was demonstrated to have a lower rate of death, myocardial infarction and stroke in high-risk patients than traditional surgery.

"We believe carotid artery stenting is an important therapy in the prevention of stroke," said Dr. Tim Swan, a Marshfield Clinic Interventional Radiologist who has performed more than 50 of these procedures at Saint Joseph's Hospital. "This is a minimally invasive alternative to traditional surgery. Patients are discharged from the hospital to resume normal activities much more quickly than the traditional method, because carotid stenting is performed under local anesthesia through a small incision in the groin."

During the procedure, the physician uses a combination of balloon angioplasty and stent implant to unblock and re-open the carotid artery, a major supplier of blood to the brain. When the stent is placed, an embolic protection system is used to collect plaque or clot that could become dislodged and potentially cause a stroke.

"In experienced hands, the risks and benefits of this procedure are nearly equivalent to traditional surgery," said Dr. Swan. "The availability of a FDA-approved device for carotid stenting provides a viable treatment alternative for a large group of high-risk patients."

Carotid endarterectomy is currently the standard surgical method for restoring blood flow within the carotid arteries, with approximately 170,000 procedures performed in the United States annually. It requires an incision in the patient's neck and artery to remove plaque and debris from inside the vessel wall, thereby reducing the incidence of a stroke.

Patients who could benefit from the less invasive stenting alternative are known to have an increased risk of complication from traditional carotid surgery. Several medical centers across the country are involved in a National Institutes of Health-sponsored study examining the effectiveness of carotid artery stenting in patients considered "normal" risk. Saint Joseph's Hospital/Marshfield Clinic is the only medical center in Wisconsin participating in this randomized controlled trial.

"We are encouraged by the positive clinical data for carotid stenting when used for high-risk patients. For the first time ever in the United States devices designed specifically for carotid stenting are now commercially available, because the Food and Drug Administration was convinced of the utility of this procedure by this same data," said Dr. Swan. "We hope that ongoing clinical studies demonstrate that this minimally invasive therapy can be safely used in all patients with carotid artery stenosis."

For more information on stroke prevention, visit the following sites: