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Carotid stent offers minimally-invasive treatment

A safety net to snare breakaway plaque is the newest advancement in carotid artery stenting — a technique several physicians at Baptist Health Louisville are using with patients who are ineligible for traditional surgery.

Comparing the procedure's outcomes to previous methods, doctors explain that without the embolic protection or safety net, the risk of stroke is about 10 percent. With it, it’s down to about 3 percent.

Baptist Louisville originally was approved by the federal Centers for Medicare and Medicaid Services for performing carotid artery stenting for high-risk patients, but now is using the procedure for all appropriate candidates.

In 2005, physicians at Baptist Louisville participated in a clinical study involving the carotid stent system. In the nationwide study, called CAPTURE – Carotid ACCULINK/ACCUNET Post Approval Trial, patients who were ineligible for traditional carotid artery surgery were instead treated by undergoing a minimally-invasive procedure. The procedure uses a combination of balloon angioplasty, a stent implant and a safety net called an embolic protection system to unblock and reopen the carotid artery, a major supplier of blood to the brain.

Much of the study’s purpose was to track results. Physicians evaluated the new procedure, determining if results are comparable to those from carotid endarterectomy — the gold standard for treatment. This traditional surgery involves making an incision in the neck and artery to remove plaque and debris to improve blood flow and lessen the chance of stroke. Not everyone is a good candidate for the surgery, due to such factors as the inaccessible location of the blockage, previous surgery or radiation therapy, anesthesia intolerance or severe illness that would prevent surgery.

With the carotid artery stent, only local anesthesia is used as a tiny incision is made in the groin. Patients remain awake and alert during the procedure, which takes one to two hours and requires an overnight stay in the hospital.
Carotid artery disease results from a buildup of plaque in one or both carotid arteries in the neck. The carotid arteries supply vital oxygen and glucose-rich blood to the parts of the brain where thinking, speech, personality and sensory and motor functions reside.

Stroke is the third leading cause of death in the United States, and the number one cause of disability in adults. Approximately 25 percent of strokes are caused by carotid artery disease. More than 700,000 Americans will have new or recurrent strokes each year, and 280,000 will die.

Baptist Louisville has been named a Primary Stroke Center for excellence in its neuroscience program, meeting national quality standards for stroke care.