New technique for opening blocked carotid arteries significantly lowers complication risk

BUFFALO, N.Y. -- Patients who need a second surgery to open a re-clogged carotid artery, the large artery on either side of the neck that serves the brain, face potential major complications, including possible damage to nerves that control eye and tongue movements and stroke.

A new procedure being tested in clinical trials at the University at Buffalo and elsewhere could change that prospect, however.

In findings presented today (Feb. 4, 2004) at the joint annual meeting of the American Society of Neurological Surgeons and American Society on Intervention Therapy Neuroradiology in San Diego, Ricardo A. Hanel, M.D., UB neurovascular fellow, reported that there were no neurological complications with the new technique in a study involving 21 patients.

Moreover, the new procedure is carried out from inside the artery, making it considerably less invasive than the established procedure for this condition, called carotid endarterectomy, which involves opening the artery and cutting out the blockage.

"For restenosis (a returned blockage in the same artery), there is no doubt that this is the way to go," said Hanel, who is affiliated with the UB/Toshiba Stroke Research Center and Kaleida Health's Millard Fillmore Hospital, where UB's Department of Neurosurgery is headquartered.

Hanel said that up to 10 percent of patients who undergo carotid endarterectomy after restenosis have major complications, including stroke and death, and up to 17 percent suffer cranial nerve palsy.

"Complications are very low with this procedure in general," he said. "In this small sample, complications were zero."

The new procedure has the cumbersome clinical name "carotid artery angioplasty with stenting (CAS) with distal embolic protection (DEP)." It adapts techniques used widely to open vessels that feed the heart to the arteries serving the brain. L. Nelson Hopkins, III, M.D., chair of the UB Department of Neurosurgery, is an international leader in

Contact: Lois Baker
University at Buffalo

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