Carotid Artery Disease

Allegheny's specialists are considered among the finest in the country at carotid stenting, offering training to professionals from around the world in this technique. Allegheny established the first carotid stent center in Pittsburgh in 2005. Medicare officially recognizes Allegheny's stent program, which also is an integral part of the hospital's renowned Stroke Center.

Mark Wholey, M.D., and his team use a non-surgical approach in treating carotid artery disease. AGH is the first carotid stent center to become Medicare certified.

Allegheny's leading role in carotid stenting has developed from a commitment to rigorous information management and outcomes research, evaluated on a regular basis by a multidisciplinary oversight committee.

The hospital unites the disciplines of interventional radiology and cardiology, as well as vascular surgery, for the cuttingedge treatment of disease affecting the carotid artery. Use of sophisticated imaging modalities — including carotid duplex imaging and CT, MR and traditional angiography — allows Allegheny's carotid artery disease specialists to initially detect blocked areas, then follow with angiograms to highlight the block's exact location and extent in preparation for treatment.

For patients in which the carotid artery is more than 70 percent blocked, endarterectomy or stenting may prevent further symptoms and, ultimately, a stroke. Removal of fatty deposits in the carotid through endarterectomy allows most patients to return home the day after surgery.

Endarterectomy may not be an option for high-risk patients, however — for instance, those with other anatomic risks factors, previous neck radiation, severe congestive heart failure, unstable angina, recent myocardial infarction, contralateral carotid occlusions or previous endarterectomies with restenosis.

Nursing personel closely monitor patients during carotid senting.

For these patients, Allegheny offers carotid stenting — a minimally invasive treatment approved by the U.S. Food and Drug .Administration in 2004. In this procedure, doctors open the artery and, using a balloon catheter, flatten the plaque against the artery wall Once the arterial passage is cleared of obstructive plaque, physicians place a stent over the plaque, which keeps the artery propped open. Through Allegheny's program, patients also may receive embolic and distal-protective devices — in essence, stents with medications that prevent future formation of plaques or clots in that area.

For information on Carotid Revascularization visit Carotid Stenosis Treatment Located at the AGH Neuroscience Center Website.