New Carotid Artery Stent System Prevents Stroke And Heart Attacks

BRIDGEPORT — Expert physicians at Bridgeport Hospital are pioneering the use of a new type of artery-clearing system as a way to prevent debilitating or possibly fatal strokes and heart attacks. Drs Robert Fishman and Edward Tuohy, both cardiologists, and Dr Gerard Muro, a neuroradiologist, were recently the first physicians in Connecticut to use the latest FDA-approved carotid artery stent with a built-in protection system to prevent clot material from reblocking blood vessels.

“This is another step forward in preventing clot material from causing new blockages in the bloodstream after the carotid artery has been reopened,” said Dr Tuohy. “By removing the clot material, the new system helps safeguard the patient against strokes and heart attacks.”

Stents — tiny stainless-steel coils — have been used successfully in coronary arteries for more than a decade to help keep them open following angioplasty procedures. Stents have also been effective when used in the carotid arteries of the neck, the major blood vessels that feed the brain. Instead of stainless steel, the carotid artery stent is made of nitinol, a self-expanding metal that takes the shape of the artery after placement.

During carotid artery stenting, a catheter is inserted through the patient’s groin and with the help of X-ray guidance carefully positioned next to the blockage in the carotid artery. A balloon at the tip of the catheter is inflated, pushing the blockage (fatty material known as plaque) to the side of the blood vessel. This helps restore blood flow through the artery. After the blockage has been pushed aside, the stent is left behind to keep the artery open. The majority of patients who undergo this procedure remain in the hospital for less than 24 hours.

The newly approved stent has an accompanying collection device, called a distal embolization protection system (distal = away from the point of origin; embolization = blockage). This fishnetlike device helps prevent strokes by trapping plaque that may break off during balloon inflation and travel through the bloodstream.

Blocked carotid arteries account for one-third of the 600,000 strokes that occur annually in the United States. Strokes are the nation’s third leading cause of death and the number one cause of long-term disability.

Prior to the introduction of carotid angioplasty and stenting, blocked carotid arteries were most commonly treated surgically, with an incision in the neck to reach the blocked artery, and surgical removal of the plaque causing the blockage.

“This can be a difficult procedure to perform for patients with high surgical risks, such as severe coronary artery disease,” Dr Fishman says. “Carotid angioplasty and stenting allows more high-risk patients to avoid strokes and other complications involved with surgery. Just as importantly, stenting reduces the risk of a heart attack during the procedure, compared to surgery.”

In 1994, Bridgeport Hospital cardiologists were the first in Fairfield County to use bare metal stents during coronary angioplasty procedures. Vascular surgeons and interventional radiologists performed the first carotid artery stenting procedure at Bridgeport Hospital in 1997. In 2002, cardiologists at Bridgeport Hospital began using stents coated with heparin, an anticlotting drug, and in 2003, working with radiation medicine specialists, they began administering small doses of radiation after angioplasty to stunt the growth of scar tissue in cleared arteries. The introduction of drug-eluting stents in 2003 took artery-clearing measures to the next level.

The Heart Institute at Bridgeport Hospital offers a comprehensive range of cardiovascular services, including open-heart surgery, angioplasty, sophisticated heart rhythm care, and cardiac rehabilitation and wellness programs. For information about expert physicians at Bridgeport Hospital who perform carotid artery stenting, call 888-357-2396.