Michael E. DeBakey VA Medical Center - Houston, Texas

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Physicians at Houston VA Offer New Procedure to Prevent Strokes

May 7, 2003

Physicians at Houston VA Offer New Procedure to Prevent Strokes

Approximately 730,000 strokes occur in the U.S. each year and about a fourth of those are fatal.

Released: 2003/05/07

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Dr. Peter Lin, chief of the HVAMC vascular surgery service, along with two other HVAMC vascular physicians, Dr. Alan Lumsden and Dr. Ruth Bush, have collectively performed more than 70 carotid stenting procedures in the past two years. Above, Lin (right) and Bush (left) check up on veteran Edward Addis, who had the procedure performed earlier that morning.

Photo by Bobbi D. Gruner, Public Affairs Officer

HOUSTON, TX - Doctors at the Houston VA Medical Center (HVAMC) are now performing a new procedure to prevent strokes. This technique involves the application of balloon angioplasty and stenting of the neck artery, also known as the carotid artery. The carotid artery provides the majority of the blood flow to the brain.

This new treatment applies the same type of techniques that cardiologists use when they place a stent in the coronary arteries to improve blood flow to the heart.

In this new treatment, a small catheter is placed in the groin area and a small wire is used to thread through the carotid artery. Next, a balloon is placed over the wire, and the balloon is then inflated to open the blocked neck artery. The fatty blockage within the carotid artery is pushed out of the way as the balloon inflates. The carotid artery is kept open by the placement of a stent, which will permanently push the fatty plaques away from the lumen of the artery; thereby, restoring the blood flow to the brain.

It is estimated that approximately 80 percent of strokes are due to blockage of the carotid artery. This new treatment is particularly useful in patients who are at high risk for undergoing the conventional operation, called carotid endarterectomy. Carotid endarterectomy is where doctors make a 6-inch incision in the neck and carve out the blocked artery to restore blood flow to the brain.

"The advantage of this procedure is that it is done without any incision in the neck. The patient remains aware during the entire procedure, and typically, the patient is discharged home the following morning. Because there is no neck incision, the recovery time is extremity short, and most patients can return to normal daily activity within 2 to 3 days." said Dr. Peter Lin, chief of HVAMC vascular surgery service.

Lin, along with two other HVAMC vascular physicians, Dr. Alan Lumsden and Dr. Ruth Bush, have collectively performed more than 70 of these procedures in the past two years.

"Our experience shows that the success of this procedure is similar to that of carotid endarterectomy operation. Moreover, the patients experienced significantly less discomfort or stress in this new procedure because of the rapid recovery time and the avoidance of the neck incision," said Lumsden.

Approximately 730,000 strokes occur in the United States each year and about a fourth of those are fatal. Stroke is like a heart attack in the brain, typically caused by fatty blockages with the neck artery that supplies blood flow to the brain.

"This new procedure offers a tremendous advantage to those high-risk patients who, otherwise, could not tolerate a carotid endarterectomy operation because of anesthetic risk. Many patients with serious heart or lung illnesses who have carotid artery blockage, can certainly benefit from this new procedure without the fear of undergoing general anesthesia," said Bush.

A randomized clinical study that was recently reported at the American Heart Association meeting in November 2002 showed that patients with high-risk medical co-morbidities experienced greater benefits and less complications following carotid stenting when compared to carotid endarterectomy.

If you are a veteran and are interested in learning more about this new treatment of the carotid artery blockage, please contact the HVAMC Vascular Surgery Clinic for more information (713) 794-7895.

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Point of Contact: VHAHOU Public Affairs

04/21/04 08:25