Carotid Stents

Less Invasive Procedure Opens Blockages

Thomas Khoury, MD, a general/vascular surgeon at Southern Ohio Medical Center, was selected by medical device developer Boston Scientific to participate in a research trial on placing stents in carotid arteries.

This procedure is used to open restricted blood pathways to the brain and prevent strokes. The research trial was conducted in Ohio at sites including SOMC, Cleveland Clinic, Riverside Methodist Hospital, The Ohio State University and Grant Medical Center.

“By using a catheter inserted through an artery in the groin, we can compress the fatty deposits and place a stent (a hollow tube) in the restriction that allows better blood flow to the brain,” Dr. Khoury explains.

“This procedure is much less invasive than conventional surgery, offering lower risk and discomfort to the patient in a process that can be done without having the patient stay a long time in the hospital,” Dr. Khoury says.

The risk factors for carotid disease are the same for coronary and lower extremity vascular disease, Dr. Khoury explains. “These include smoking, diabetes, high cholesterol/triglycerides, family history and hypertension,” he says.

Dr. Khoury has already been performing the procedure on patients at SOMC.

“The typical patient is someone who has presented symptoms indicating a stroke may be forthcoming, or in which certain testing has revealed a restriction in the carotid artery,” he says.

“We conduct tests to reveal the current state of the patient’s arteries and reveal blockages and strictures to blood flow. If the patient meets certain criteria we can perform a carotid stent procedure as opposed to conventional surgery. This is often an excellent alternative for individuals who are not good candidates for surgery.”

During the procedure, a membrane is temporarily placed beyond the point where the stent will be placed, serving as a filter to catch any debris that may break off during the process. Without this important filter, if debris breaks loose it can travel toward a smaller arterial branch and block blood flow, causing a stroke.

“We are constantly monitoring the patient’s status during the procedure, so the patient stays awake and is asked periodically to squeeze a rubber ball or toy,” Dr. Khoury says. “This way we know the patient is alert and responding.”

Dr. Khoury has performed more than 400 carotid endarterectomies and more than 2,000 angiograms and endovascular procedures locally.