Home > Media Relations > Mercy News Archive

Media Relations: Mercy News Archive

Dr. Luis Queral and the Vascular Center at Mercy Offers Patients Option of Carotid Stenting

The traditional way to treat a narrowed carotid artery in the neck is to surgically open the artery through an incision and clean it out.

It's a time proven operation that works well, but using stents is an option for high-risk patients. Dr. Luis Queral with Mercy Medical Center said it is the most exciting thing happening in vascular surgery right now.

"In certain patients that are at high risk for the traditional surgery, we can place a stent at the splitting of the carotid in the neck and thereby reduce the risk of stroke," Queral said.

From the groin, a wire is passed through the femoral artery to the carotid, past the narrowing, and a wire basket is opened to catch any particles that might break off and cause a stroke. A balloon angioplasty is performed to wide the blockage, and a stent is put in place to keep the blockage open.

"It's a minimally invasive alternative to the conventional open carotid surgery, which requires an incision in the neck," said Mercy vascular surgeon Dr. Paul Lucas. "What this wire typically has on it is a filter device that we open like a basket."

The basket stops debris from traveling to the brain and causing a stroke during balloon angioplasty.

"A lot of times we'll predilate the narrowed area with a balloon. And what that does is it opens up the vessel a little bit and allows easier passage of our stent," Lucas said.

"Typically the stents that we use are self-expanding, so in a loaded position the stent is crimped inside the catheter. And as we release the catheter around it, the stent will expand on its own," he said.

Once in place, the stent keeps the artery open so blood can get to the brain.

"(The) main disadvantage of stenting is we don't know what it is going to look like in 5 to 10 years down the road," Queral said. "It does solve the problem initially and with about the same risk as surgery."

To find out the long-term effects of stenting, Queral said studies are ongoing. For healthy, relatively young people, he thinks traditional surgery is probably the best bet.