Stopping strokes before they strike

July 7, 2009 3:38:18 PM PDT
Stroke is the third leading cause of death in the United States. New technology is helping doctors catch a stroke before it strikes.

Robert Murphy, 74, had a stroke seven years ago that paralyzed him. He was lucky to recover. That wasn't all.

"He had the sonogram of the carotid artery and it was found to be quite blocked," his wife Clara said.

The carotid artery bringing blood to his brain was narrowed by cholesterol, and he was at high risk of another stroke.

Doctors will put a metal stent into the artery to open it again.

To prevent pieces of cholesterol from breaking off while putting in the stent, a tiny sponge will act as a filter.

Filters have been used before, but this one is different.

"(The sponge) has smaller pore size, and it may collect smaller cholesterol debris that may chip off," Dr. Thomas Maldonado of NYU Langone Medical Center said.

Chip off and actually cause a stroke. In the operating room, the sponge is threaded through a leg artery to the carotid and expanded. The stent goes up behind it.

The operation is obviously to treat carotid blockage. The idea, though, is to prevent it from happening in the first place.

Treating high blood cholesterol, high blood pressure, and not smoking reduce your risk.

Back in the operating room, the sponge is upstream in Mr. Murphy's carotid. It's followed by the stent, which is opened by a balloon. Any fatty particles broken off are trapped in the sponge.

After the operation, you can see the particles of cholesterol, which are washed off the sponge after removal. Each could have caused a mini-stroke.

Besides carotid disease, there are other causes of stroke, especially heart problems.

"Any person who has a stroke should be worked up for the cause of the stroke. Not all are from the carotid artery," Maldonado said.


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