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'Stent-Graft' procedure improves outcomes of carotid aneurysm repair
March 08, 2006Less-invasive technique speeds recovery, reduces complications
For patients with life-threatening aneurysms of the carotid artery in the neck, a minimally invasive stent-grafting technique can be just as effective as traditional open surgery, but with faster recovery and fewer complications, according to a study in the March Journal of Vascular Surgery.
"Minimally invasive treatment using a stent-graft to repair the carotid artery aneurysm (CAA) has become a useful strategy to treat patients with this condition," said Dr. Peter Lin, Associate Professor of Vascular Surgery at Baylor College of Medicine, one of the study authors. "Compared to the open neck operation, we found that the stent-graft approach resulted in less neck nerve injury and faster recovery."
An aneurysm is a ballooning of an artery, resulting from weakening or stretching of the vessel wall. The carotid artery, which is the main blood vessel in the neck, supplies most of the blood flow to the brain. When an aneurysm occurs in the carotid artery, it can get bigger over time, leading to devastating problems such as stroke or rupture of the aneurysm. A CAA can occur after trauma, infection, or previous surgery of the carotid artery.
The researchers compared the results of CAA repair in two eras: 1985 to 1994, when 22 patients were treated by open neck surgery; and 1995 to 2004, when 14 of 20 patients were treated by minimally invasive endovascular procedures such as stent-graft placement. In the stent-graft procedure, the vascular surgeon makes a small incision in the groin to thread a catheter through the patient's arteries. Once the catheter reaches the carotid artery, a small device called a stent-graft is placed inside the aneurysm. The graft is then expanded and fixed in place to repair the aneurysm.
Both approaches had a high success rate, but stent-graft placement offered some important advantages over surgery. Because it doesn't require any incision in the neck, patients undergoing the stent-graft procedure had much less pain and discomfort, with a shorter recovery time. Stent-grafting also had fewer complications, including a lower risk of injury to the cranial nerve in the neck.
"Patients who undergo the carotid artery stent graft procedure can typically resume their normal activities within two days following the treatment," said Dr. Wei Zhou, a co-author of the study. "This is in contrast to two to three weeks of recovery if they undergo the conventional open neck operation. With patients who have underlying lung disease and do not tolerate general anesthesia, this catheter-based procedure can be performed under local anesthesia."
However, the researchers cautioned that not every patient with a CAA is a good candidate for the stent-graft treatment. In some situations, open surgery remains the preferred treatment because the vessel anatomy may not accommodate the placement of a stent-graft. Doctors are hopeful that, with continued advances in technology, this minimally invasive treatment may become more widely applicable in patients with carotid artery aneurysms.
Elsevier
An aneurysm is a ballooning of an artery, resulting from weakening or stretching of the vessel wall. The carotid artery, which is the main blood vessel in the neck, supplies most of the blood flow to the brain. When an aneurysm occurs in the carotid artery, it can get bigger over time, leading to devastating problems such as stroke or rupture of the aneurysm. A CAA can occur after trauma, infection, or previous surgery of the carotid artery.
The researchers compared the results of CAA repair in two eras: 1985 to 1994, when 22 patients were treated by open neck surgery; and 1995 to 2004, when 14 of 20 patients were treated by minimally invasive endovascular procedures such as stent-graft placement. In the stent-graft procedure, the vascular surgeon makes a small incision in the groin to thread a catheter through the patient's arteries. Once the catheter reaches the carotid artery, a small device called a stent-graft is placed inside the aneurysm. The graft is then expanded and fixed in place to repair the aneurysm.
Both approaches had a high success rate, but stent-graft placement offered some important advantages over surgery. Because it doesn't require any incision in the neck, patients undergoing the stent-graft procedure had much less pain and discomfort, with a shorter recovery time. Stent-grafting also had fewer complications, including a lower risk of injury to the cranial nerve in the neck.
"Patients who undergo the carotid artery stent graft procedure can typically resume their normal activities within two days following the treatment," said Dr. Wei Zhou, a co-author of the study. "This is in contrast to two to three weeks of recovery if they undergo the conventional open neck operation. With patients who have underlying lung disease and do not tolerate general anesthesia, this catheter-based procedure can be performed under local anesthesia."
However, the researchers cautioned that not every patient with a CAA is a good candidate for the stent-graft treatment. In some situations, open surgery remains the preferred treatment because the vessel anatomy may not accommodate the placement of a stent-graft. Doctors are hopeful that, with continued advances in technology, this minimally invasive treatment may become more widely applicable in patients with carotid artery aneurysms.
Elsevier
Carotid Artery Current Events and Carotid Artery News RSSVitamin B niacin offers no extra benefit to statin therapy in seniors already diagnosed with CAD
The routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease, a new vascular imaging study from Johns Hopkins experts shows.
Brain injured athletes may benefit from hypothermia research
NFL players and other athletes who suffer serious or multiple concussions may benefit from ground-breaking research being conducted by scientists at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center. The scientists are developing a surgical technique that involves hypothermia in specific regions of the brain.
Early end to key study on benefits of niacin, a B vitamin, in keeping arteries open was premature
Heart experts at Johns Hopkins are calling premature the early halt of a study by researchers at Walter Reed Army Medical Center and Washington Hospital Center on the benefits of combining extended-release niacin, a B vitamin, with cholesterol-lowering statin medications to prevent blood vessel narrowing.
Higher carotid arterial stenting rates associated with poorer clinical outcomes
Among eligible Medicare beneficiaries, increased use of carotid arterial stenting (CAS) procedures to treat carotid stenosis-the narrowing of the carotid artery-is associated with higher rates of mortality and adverse clinical outcomes, including heart attack and stroke, according to researchers from the University of Pennsylvania School of Medicine.
Smoking gun: just 1 cigarette has harmful effect on the arteries of young healthy adults
Even one cigarette has serious adverse effects on young adults, according to research presented by Dr. Stella Daskalopoulou at the Canadian Cardiovascular Congress 2009, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.
Ice cream may target the brain before your hips, UT Southwestern study suggests
Blame your brain for sabotaging your efforts to get back on track after splurging on an extra scoop of ice cream or that second burger during Friday night's football game.
Childhood obesity: The increasing vascular drama
Obesity is one of the most important health problems in industrialized countries irrespective of socio-economic status, age, sex or ethnicity.
Study indicates that a common virus could cause high blood pressure
A new study suggests for the first time that cytomegalovirus (CMV), a common viral infection affecting between 60 and 99 percent of adults worldwide, is a cause of high blood pressure, a leading risk factor for heart disease, stroke and kidney disease.
Hypertension, Diabetes and Increased Carotid Artery Wall Thickness Means Increased Risk of Stroke
Increased carotid artery wall thickness (CAWT), which can cause heart attack and stroke in many patients, is significantly related to diabetes and hypertension, according to a study performed at A.O.U. in Cagliari Sardegna, Italy (Chairman, Professor Giorgio Mallarini).
Daytime sleepiness provides red flag for cardiovascular disease
Clinicians should be alert to patients reporting "excessive" day time sleepiness (EDS), says the European Society of Cardiology, after a French study found healthy elderly people who regularly report feeling sleepy during the day have a significantly higher risk of dying from cardiovascular disease.
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