Page 16 - SOUTH FLORIDA HOSPITAL NEWS AUGUST 2021

A New Approach to Stroke Prevention

Collaboration among Road Medical, which Memorial almost completely blocked carotid artery
physicians with differing recently became the first in Broward and was somewhat fortunate to have not
expertise in a multi-discipli- County to perform, also involves already had a stroke by the time he came
nary approach to care, and direct access to the carotid artery, to the Memorial Cardiac & Vascular
ensuring the optimal treat- but through a much smaller inci- Institute. Because of his age and a recent
ment for specific conditions, sion at the base of the neck, just bout with COVID-19, he was not a real-
is one of the most gratifying above the clavicle. istic candidate for CEA.
aspects of medicine. That was During the procedure, a tube Following the procedure, the patient
certainly the case when a new inserted into the artery is connected spent just one night at the hospital for
procedure being done within to a system that temporarily revers- observation and was walking immediate-
Memorial Healthcare System es blood flow, directing it away from ly after. He reported feeling “like a new
brought together vascular the brain and keeping dangerous man” and is now taking nothing stronger
and neurointerventional sur- plaque debris from flowing in that than aspirin as a blood thinner and a
gical teams to reduce a BY SEAN O’DONNELL, MD, AND BRIJESH MEHTA, MD direction. cholesterol-lowering medication to help
patient’s risk of stroke. While the brain still receives prevent future issues.
blood through other arteries, sur- While CEA is recognized as a safe,

Probable Cause Latest Technology geons filter the blood from the carotid effective surgery, it’s still a fairly major
Strokes are both cardiovascular and “TCAR,” short for TransCarotid Artery artery and implant a stent to open the operation that takes time and usually
neurological incidents, occurring when Revascularization, is an option for narrowed artery and prevent future requires general anesthesia. We’ve found
the blood supply from the heart to the patients with severe plaque buildup that strokes. Blood is returned from a tube TCAR to be an important, new option in
brain is interrupted or reduced. This are beyond the point where medication connected to the carotid artery, passes the fight against strokes that is particu-
deprives the brain of oxygen and nutri- or lifestyle changes will help. In these sit- through a filter, and returns from the larly suited for patients like Reynold that
ents and causes cells to die. Stroke is the uations, where the risk of stroke is signif- other end of the tube into a vein in the are at higher risk of complications from
5th leading cause of death in the U.S. and icant, the traditional approach would be groin, with the normal direction of flow the traditional treatment of carotid artery
more than 15 million people worldwide carotid endarterectomy (CEA) surgery, resumed following the procedure. disease.
are affected by strokes each year, with an open surgical procedure to unblock When compared to CEA, there is less
many passing away or becoming perma- arteries. stress on the heart and the risk of the
nently disabled. Some patients, however, may not be patient having a stroke or heart attack Dr. Sean O’Donnell is a vascular surgeon
While there are several potential caus- candidates for this surgery, either during the process is significantly and the medical director of Vascular and
es for a stroke, it’s estimated that nearly a because of age, anatomic issues, heart decreased. Endovascular Surgery at Memorial Cardiac
third are brought on by carotid artery disease, or other comorbidities. & Vascular Institute. Dr. Brijesh Mehta is a
disease, a buildup of plaque in one or Additionally, as with any invasive proce- First Patient neurointerventional surgeon and medical
both of the arteries in the neck that can dure, the patient’s recovery period is Following a review of clinical informa- director of the Comprehensive Stroke
affect the flow of blood to the brain. longer and more arduous than those tion and imaging studies by vascular and Program and Neurointerventional Surgery at
When portions of plaque from a diseased whose repairs are done with less invasive neurointerventional teams, we per- Memorial Neuroscience Institute.
carotid artery travels to a small artery in methods. formed our first TCAR procedure on For more information about Memorial
the brain, blood flow is interrupted and a TCAR, a procedure pioneered by Silk Reynold, an 81-year-old man with Healthcare System, visit www.mhs.net.
stroke occurs. advanced coronary disease. He had an

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16 August 2021 southfloridahospitalnews.com South Florida Hospital News