Carotid Artery Stenosis is a common cause of stroke. In fact, roughly 7 to 18% of all first time stroke is attributed to carotid artery stenosis in excess of 60%. That means that roughly 1 in 10 strokes is due to narrowing of the carotid artery.
There is debate regarding the best treatment for carotid artery stenosis. I won’t get into the relative risks and benefits of each in this post, but in general the treatment options for carotid stenosis include:
Medical Treatment – aggressive medical treatment usually involves aspirin, clopidogrel, a statin, as well as aggressive blood pressure and diabetes control. This may be the best option for asymptomatic carotid stenosis.
Carotid Endarterectomy (Surgery) – this is a surgical procedure in which an incision is made on the neck and the carotid artery is exposed. The artery is then temporarily occluded with clamps. The artery is then opened with a scalpel, the plaque is removed, and then the artery is repaired. This has been a common treatment for many decades, and is well studied with very good results.
Carotid Angioplasty and Stent (Endovascular Treatment) – this is an endovascular procedure to treat carotid disease. This is done awake in the
cath lab. A guide sheath is placed into an artery in the leg, it is navigated to the common carotid artery in the neck, and then the carotid narrowing is treated from within the blood vessel. The narrowed carotid artery is ballooned opened with a balloon catheter and a stent is placed to help keep the artery open. In the images to the right and below, there is a representative example of the treatment of left internal carotid stenosis with angioplasty and stent placement. In the image to the right, the narrowing is a tiny string of contrast at the arrow, which is causing severe limitation in flow into the left internal carotid artery. Below, you can see the post angioplasty and stent results, after the narrowing has been “ballooned open” and a stent placed.
Dr. Lawson treats carotid disease with all of the methods noted above; medical, surgical, and endovascular. All of his carotid procedures are tracked in a registry (the National Neurosurgery Quality and Outcomes Database, also known as QOD – Neurovascular module) to ensure quality and safety. Learn more about public quality data reporting at the Neuropoint Alliance.
Want to learn more? Download the American Stroke Association guidelines for the management of carotid disease here.
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I’m pleased to be one of the invited speakers to the Baptist Health Care Stroke Symposium in Pensacola, set for May 19, 2017. I’ll be speaking about Hemorrhagic Stroke as well as the role of the TMH Comprehensive Stroke Center in our community.
This conference is geared for all health care providers, including physicians, ARNPs/PAs, nurses, therapists, and EMTs/paramedics. CEUs are provided.
Tallahassee Memorial Hospital received the American Stroke Association Get with the Guidelines Gold Plus recognition for excellence and consistency in compliance with stroke center quality measures. Great job team!
June 7, 2016 – TMH announces their new designation as a Comprehensive Stroke Center by the Agency for Healthcare Administration, making TMH the only Comprehensive Stroke Center in the region. TMH has received the American Stroke Association “Get with the Guidelines” Gold Plus recognition for stroke care, and we are proud to be the only hospital within hundreds of miles with the Comprehensive Stroke Center designation.
Dr. Lawson and his partner, Dr. Oliver, are the only board-certified neurosurgeons in the region with advanced certification in endovascular neurosurgery (CAST certification). They treat nearly 100 brain aneurysms per year, perform cutting edge thrombectomy procedures for the treatment of acute stroke, and countless other cerebrovascular procedures.
Together, TMH and Tallahassee Neurological Clinic are setting the standard for stroke and cerebrovascular care in Florida’s panhandle, south Alabama, and south Georgia.
Dr. Lawson presented a lecture on treatment of Acute Stroke and the MR CLEAN trial results at the TMH Cardiovascular Symposium. The second annual conference of its kind included over 100 medical attendees.
Dr. Lawson & Dr. Oliver have successfully treated over 100 cerebral aneurysms at Tallahassee Memorial Hospital. In just two years, TMH has become a major regional referral center for brain aneurysms and other cerebrovascular disorders.
In September of 2012 Tallahassee Memorial Hospital opened a state-of-the-art facility for performing complex neuro-endovascular procedures. One year later, 167 cases have been performed, dramatically improving the quality and availability of cerebrovascular care in the region.
Since the opening of this facility, we have successfully treated the following conditions:
Ruptured Brain Aneurysms
Unruptured Brain Aneurysms
Idiopathic Intracranial Hypertension