Published on April 18, 2019

Concord Hospital Offers New Option to Some Patients With High Stroke Risk

Certain patients with a higher risk of stroke because of blocked or narrowed carotid arteries now can be treated at Concord Hospital with an advanced endovascular technique.

The carotid arteries are the two major arteries in the neck that carry oxygen-rich blood to the brain. When plaque builds up inside the arteries, the flow of blood is reduced, causing a condition called carotid stenosis.

Standard treatment for most carotid stenosis patients is to surgically open the artery and clean out the plaque. However, open surgery is not an option for some patients, including those with heart conditions, those who have undergone the open surgery previously, or because of the location of the blockage.

Instead of being referred elsewhere, those high-risk patients now can be treated at Concord Hospital with a minimally invasive procedure called carotid stenting, in which a stent, or mesh-like tube, is expanded inside the artery to hold it open.

Dr. Sebastiano DiDato of Concord Hospital Medical Group Concord Surgical Associates performed the Hospital’s first carotid stenting in January for a Hillsborough resident who underwent successful open surgery three years ago but developed a second blockage.

For the stenting procedure, rather than making an incision in the neck, surgeons reach the blockage by threading a tiny filter, balloon, and stent into the artery through a small incision in the femoral artery in the groin.

Dr. DiDato explained that the filter is moved beyond the blockage to make sure any plaque dislodged during the procedure is captured before it can flow to the brain. Then, a balloon is moved to the narrowed section of the artery and inflated to widen the artery enough to thread a stent into place. A second balloon expands inside the stent to open it against the inside of the artery wall. With the stent locked open, the balloon and filter are withdrawn and proper blood flow is restored, reducing the patient’s risk of stroke.

Concord Hospital expects about 10 patients a year will benefit from carotid stenting, which requires extensive, specialized training and a large medical team. The Hospital and the providers required federal accreditation before being approved to perform the procedure.

Concord Hospital’s program is a collaboration between vascular surgery, interventional radiology, and interventional cardiology. Drs. DiDato, Ari Salis and Shahab Moossavi are credentialed to perform the procedure.

“We are excited and fortunate to have the talent here at Concord Hospital to be able to perform this procedure for our patients locally,” said Concord Hospital Stroke Program Manager Christina Swanberry. “It’s another tool to help us prevent strokes in our community.”

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