FDA Approves Carotid Artery Stenting for Standard Risk Patients

South Florida Interventional Radiologist One of First in the Region to Perform Procedure

COCONUT CREEK (August 19, 2001)-Carotid Artery Disease occurs when the major arteries in the neck become narrowed or blocked. “These arteries are the main supplier of blood to the brain; when blocked, they often cause strokes or in some cases, be fatal,” explained William Julien, MD, medical director of South Florida Vascular Associates. Carotid Artery Stenting is a minimally invasive procedure used to re-open the carotid arteries, restoring blood flow and preventing stroke.

In May 2011, The Food and Drug Administration approved Carotid Artery Stenting for use in standard risk patients. Previously, only patients at high risk for surgery were approved for the procedure.  High risk patients are typically older, sicker or have abnormalities of their neck that make it difficult for a surgeon to operate.

More than 60% of United States patients are standard risk. Now patients who need carotid revascularization have the option of choosing a minimally invasive procedure rather than traditional open surgery known as an endarterectomy, which is a major surgical procedure performed under general anesthesia. During carotid stenting, a tiny incision the size of a pencil head is made in the patient’s groin and the doctor inserts a specially designed guide wire with a filter that is placed beyond the site of the narrowing or blockage in the carotid artery. Once the filter is in place, a small balloon catheter is guided to the area of the blockage. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened to increase blood flow. The balloon is removed and a stent is placed inside the artery to widen the opening and support the artery wall. The final step is to remove the filter device along with any particles that may have been trapped during the procedure. The patient typically spends one night in the hospital and is able to resume their normal activities immediately. 

With traditional endarterectomy surgery the patient experiences more pain and must remain in the hospital for several days. The incision also leaves unsightly post operative scars on the neck.  The recent FDA approval for carotid stenting is likely to have a significant impact on how many patients are now able to be treated for carotid artery disease.

75-year-old Dent Lackey experienced a 4-hour dizzy spell in April 2011. The Tamarac resident, who plays the bass fiddle for local bands, was encouraged by his family to go to the emergency room. “I felt fine except for the dizziness,” said Lackey.  “I had no other symptoms and was not dizzy any other time. If it weren’t for my children, I would not have gone to the hospital.” But he’s sure glad he did. A number of tests revealed he had severe stenosis or plaque build-up in his left carotid artery.

Lackey was referred to Dr. William Julien, an interventional radiologist in Coconut Creek. He was one of the first doctors in South Florida to perform carotid artery stenting in 2004 when it was first approved by the FDA for high-risk patients. Dr. Julien discovered Lackey had 85% blockage of the left carotid artery. This could have led to a severe stroke or been fatal if it was ignored.

Lackey was given the choice of endarterectomy or stenting. Some patients are not candidates for stenting because of anatomical issues such as extreme calcification or unusually curvy vessels. Fortunately for Lackey he was a candidate. During the procedure, Dr. Julien was able to re-establish blood flow to the arteries. “He is currently asymptomatic with no signs or symptoms of stroke. He is doing well on Plavix and aspirin daily,” added Dr. Julien.

Resistant at first to going to the doctor, Lackey is now singing a different tune. “I am so grateful that I was referred to Dr. Julien and that I learned about other options than surgery.  I am lucky to be alive.”  Just this month, he felt so good Lackey traveled to Ireland for a family vacation and will be able to continue playing his bass fiddle which is his passion and his livelihood.
About South Florida Vascular Associates

Dr.William Julien is the medical director of South Florida Vascular Associates and is one of few interventional radiologists in the nation to offer a clinical-based practice. His philosophy is to treat the patient as a whole person and does much of his own testing and procedures in his new state-of-the-art facility equipped with 3-in-office operating suites. This allows patients to feel more comfortable in a non-hospital setting. His highly-skilled staff provides one-on-one attention to each patient focusing on his/her needs and care.

To find out more about Dr. Julien and South Florida Vascular Associates call 954-725-4141 or visit www.southfloridvascular.com

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