New procedure safely opens blocked carotid arteries, experts say

Just as arteries to the heart can become plaque-ridden and cause a blockage, so can the two carotid arteries that supply blood to the brain. Every year, more than 300,000 people in the United States are diagnosed with such a blockage and if left untreated, it can reduce or even stop blood flow to the brain, causing a potentially disabling stroke.

Current treatment options include traditional open surgery to clean out the carotid artery and a minimally-invasive alternative that uses a stent to keep the artery open. However, each option has some limitations. The traditional surgery involves a large incision along the neck and carries risk of surgical complications. The stent procedure is less invasive, but some studies have shown that it causes a higher risk of stroke than the surgical procedure.

Now, a new technique and device system is being tested called Transcarotid Stenting with Dynamic Flow Reversal, or the Silk Road Procedure. It allows physicians the ability to deliver a stent directly into the carotid artery from the neck, offering a shorter, potentially safer route than the usual method of guiding a stent from an artery in the groin, which carries a risk of plaque dislodging along the way. The loose plaque can travel via the blood and cause a blockage in an artery leading to a possible stroke.

A unique aspect of the new system is the ability to temporarily divert blood flow away from the plaque during the procedure to help ensure that the patient's brain is fully protected from plaque debris at all times. Physicians redirect blood flow from the carotid artery where the team is working into tubing set up outside the body and then back into the body via the femoral vein located near the groin.

"We're always seeking new options for patients with the ultimate goal of treating these carotid artery blockages with the least procedural risk," said Dr. Wesley Moore, UCLA study investigator and professor emeritus of vascular surgery, David Geffen School of Medicine at UCLA. "We look forward to contributing to this important research."

Ronald Reagan UCLA Medical Center is one of 25 centers around the world participating in the study, called the ROADSTER trial, designed for high surgical risk patients who may be older or have especially narrowed arteries.

The study is funded by Silk Road Medical, developers of the Transcarotid Stenting with Dynamic Flow Reversal system.