Procedure to open blocked carotid arteries tested

The carotid arteries, shown above, feed blood to the brain. Doctors at Washington University are testing an investigational device designed to open blocked carotid arteries in patients whose age or poor health makes them ineligible for the traditional open surgery. Credit: SILK ROAD MEDICAL, INC.

The procedure is called transcarotid stenting with dynamic flow reversal. “The term ‘transcarotid’ refers to the technique of delivering a stent directly into the carotid artery from a small incision in the neck,” said Jim, an assistant professor of surgery. “It is a shorter and potentially safer route than the traditional minimally invasive method of stenting via the groin. And it can be done using local anesthetic.”

The “dynamic flow reversal” part of the procedure refers to a device that temporarily reverses blood flow in the blocked artery, diverting it away from the brain and into tubing set up outside the body. Filters in this tubing remove any plaque debris knocked loose during placement of the stent. The tubing then directs the blood back into the body through a vein near the groin. Since blood enters the brain through multiple arteries, patients are not adversely affected by this temporary flow reversal in a single vessel.

“Temporarily reversing the flow ensures that the patient’s brain is protected at all times,” said Jim. “This procedure holds the potential to optimize treatment for our older, high-risk patients. Because it is less invasive, there likely is a lower risk of cardiac complications and patients can recover faster.”

Washington University School of Medicine is one of 25 centers around the world participating in the clinical study, which is expected to enroll 140 patients. The study is funded by Silk Road Medical, developers of the transcarotid stenting with dynamic flow reversal system. Via Procedure to open blocked carotid arteries tested.

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