Stenting and Angioplasty with Protection in Patients at High-Risk for Endarterectomy
(Endarterectomy is the surgical removal of the inner layer of an artery when narrowed or blocked.)

Purpose

To collect data about the stent, the distal (area beyond the narrowed artery) protection device, and the patients who are treated with it

Principal Investigator

James Williams, MD, FACS, FCCP, FACC
Cardiac, Thoracic and Endovascular Therapies

For More Information Contact

Albina Underwood, RN (309) 672-4767
aunderwood@mmci.org

Summary

The carotid arteries are the two major vessels that supply blood to the head and brain. A blockage (occlusion) or narrowing (stenosis) in a carotid artery can be treated with a procedure called carotid stent supported angioplasty.  Angioplasty is an effective method of opening blood vessels in the neck, heart and legs. 

A stent is an elastic-like metal tube that is used to hold open a narrowed part of a blood vessel.  An embolic protection system is a wire mesh basket designed to catch an embolus (material such as a blood clot or fatty particle) that could break off from the narrowed area of the blood vessel during the procedure.  This material could block blood flow to the arteries beyond the narrowed area of the artery and be harmful to the brain.

The name of the stent that will be used is the Cordis PRECISE® Nitinol Stent System.  The name of the embolic protection system is the Cordis ANGIOGUARDTM XP/RX Emboli Capture Guidewire (ECGW).  Both of these devices have been approved by the Food and Drug Administration (FDA).

The stenting procedure will be done is a similar way to an angiogram (x-ray pictures of the carotid arteries).  Dye will be injected into the arteries.  A small flexible catheter with a metallic stent at the end will be placed in the narrowed area of the carotid artery.  This catheter is put in place with the aid of a very thin guidewire called ANGIOGUARDTM XP/RX.  It has a tiny filter basket at the end.  When the stent is opened it expands and presses the plaque against the blood vessel wall.  This makes the opening inside the carotid artery wider.  The catheter and guidewire are removed.  The stent remains in the body to keep the artery open.  A balloon catheter may be used during the procedure to prepare the artery for the stent.  It may also be used to help the stent open all the way.

Patients who receive the stent will be seen by their doctor 30 days after the procedure for a check-up to see that the stent is working well and to see if they have had complications from the procedure.  A neurologist (a physician who specializes in conditions that affect the brain) or study nurse will perform a neurological exam before the procedure, within 24 hours after the procedure and at the 30 day follow-up visit.  A blood sample for cardiac enzyme levels will be taken 8 to 24 hours after the procedure to check the heart.  Patients will also complete a questionnaire about how their symptoms impact their day to day life before the procedure and 30 days after the procedure when they see their doctor for their check-up.