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New Blood Flow Reversal System with Physiological and Hemodynamic Advantages

by Ana
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Charles Ross and Jeffery Dattilo, two Vanderbilt vascular surgeons, are studying the “Embolic Protection with Flow Reversal”, a new technique for carotid artery stenting. This new technique reverses blood flow to ease the risk of stroke during the minimally invasive procedure.Dattilo and Ross, both assistant professors of Surgery, are leading this clinical study as the principal investigator and co-investigator, respectively. This study is specifically focused on testing the safety and efficiency of the “GORE Neuro Protection System”.

It has been conducted in selected centers in the United States and ‘Vanderbilt Heart and Vascular Institute (VHVI)’ is one of those 30 sites which would be providing the patients, this new technique while undergoing the surgery with minimal invasive procedure.

During the first case study patients underwent the surgery for a block in carotid artery, the artery which supplies blood to the brain. The situation was grave as the block in the artery was located at the side of the neck, placing the patient at high risk for stroke. Blocks in the carotid artery are major cause of strokes. About 30% of strokes happen due to them.

Ross explained the significance of correction of carotid blockage as the risk of first-time and recurrent strokes could be reduced to a considerable extent.

The procedure involved insertion of a sheath or balloon system from the patient’s femoral artery in the groin into his carotid artery in the neck. After joining the system to the patient’s femoral vein, which contains a filter, the carotid balloons were inflated. This helped in reversing the flow of the blood naturally from the carotid artery to the low-pressure venous system, keeping it away from the blocked internal carotid artery and the brain. Blockage was treated then with balloon angioplasty and stenting.

Dattilo said that reversing the flow of the blood helps in filtering out of the system, all of the debris or fragments which have broken loose. This can be done with utmost safety by not letting it go towards the brain.  This system works well due to the physiology and hemodynamics of most people.

This technique can be seen as a major step in improving the safety of carotid artery stenting. It provides a major edge over the popular techniques like use of a miniscule basket above the blockage to function as a filter. Unlike these methods, this new system involves less changes of clogging of blood and can easily handle large volumes of plaque and debris, thereby reducing the risk of stroke to a minimum.

Besides this, surgeons are also testing the efficacy of other procedures like Carotid endarterectomy, second most commonly used procedure in removal of block. It is an open procedure in which the surgeon removes the plaque surgically.

Surgeons are evolving better ways to use these procedures most efficiently for the patients who are at high risk for complications.

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