Page 17 - Cannabis News Florida August 2021 Revised
P. 17

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
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