Doctors at Ronald Reagan UCLA Medical Center have become the first on the West Coast to perform a new, less-invasive procedure to help clear plaque-ridden carotid arteries. The procedure, which is part of a clinical trial, took place on March 28.
Just as arteries to the heart can become clogged with plaque, causing a blockage, so can the two carotid arteries that supply blood to the brain. Every year, more than 300,000 people in the U.S. are diagnosed with such blockages, which, if left untreated, can reduce or even stop blood flow to the brain, causing a potentially disabling stroke.
Current treatment options include the traditional "open" surgery approach to clean out the carotid artery and a minimally invasive alternative that uses a stent to keep the artery open.
Each of these options has some limitations. Traditional surgery involves making a large incision along the neck and carries the risk of surgical complications. While less invasive, the stent procedure requires the insertion of a catheter through an artery in the groin to guide the stent into place, which can potentially dislodge plaque; loose plaque can travel through the bloodstream and cause a blockage. Some studies have indicated that the stent procedure carries a higher risk of stroke than the surgical procedure.
The new technique and device system being tested at UCLA is called transcarotid stenting with dynamic flow reversal, or the Silk Road Procedure, which allows physicians to deliver a stent directly into the carotid artery from the neck, offering a shorter, potentially safer route than the typical stent procedure.
A unique aspect of the new system is the ability to temporarily divert blood flow away from the plaque during the procedure to help ensure that a patient's brain is fully protected from plaque debris at all times. Physicians redirect blood flow from the carotid artery where the team is working into tubing set up outside the body and then back into the body through the femoral vein, near the groin.
Ronald Reagan UCLA Medical Center is one of 25 centers around the world participating in the clinical study, called the ROADSTER trial, which is designed for high–surgical risk patients who may be older or have especially narrowed arteries.
"We're always seeking new options for patients with the ultimate goal of treating these carotid artery blockages with the least procedural risk," said Dr. Wesley Moore, UCLA study investigator and a professor emeritus of vascular surgery at the David Geffen School of Medicine at UCLA. "We look forward to contributing to this important research."
The study is funded by Silk Road Medical, developers of the transcarotid stenting with dynamic flow reversal system.
For more information on the clinical trial at UCLA, please call 310-206-1115.