Porter Health System was recently selected to participate in a clinical study to investigate the use of carotid stents in high surgical-risk patients. Porter hospital was selected by The Center for Medicare and Medicaid (CMS) and Abbott Vascular as a site for the CHOICE program. It is one of only two hospitals in Northwest Indiana approved for the study.

Interventional Cardiologist Sandeep Sehgal, MD, said to gain approval to be one of the study sites was a painstaking process and that he and Dr. Keith Atassi worked closely with CMS and Abbott to bring the study to Porter.

“I think being selected says a great deal about Porter’s commitment to excellence and to the quality of care we offer our patients,” Sehgal said.

One of the goals of the study is to gather data about the benefits of performing carotid artery stenting in patients who are at high risk for stroke and are not having symptoms, yet are considered high risk for undergoing carotid endarterectomy. The latter is the surgical removal of the inner lining of the carotid artery. The surgery is the gold standard for treating carotid artery stenosis, which is the narrowing of the aortic valve of the heart. However, not every partient can undergo the surgery, including those who have had previous radiation or surgery to the head because they cannot tolerate the anesthesia. Inserting a stent to open the narrowed carotid artery does not require general anesthesia.

Currently, CMS only approves carotid artery stenting for high-risk patients who have had a stroke or a transient ischemic attack. Clinical evidence gathered through the CHOICE trial will be reviewed by CMS to see if stenting for high-risk patients who are having no symptoms proves to be a valid treatment method. If the results are positive, CMS may reconsider its policy.

According to the American Heart Association, stroke is the third leading cause of death in the United States and the number one cause of disability in adults, and approximately 25 percent of strokes are caused by coronary artery disease. “Obviously, if we can successfully treat high-risk patients before they have a stroke, it will greatly improve their chances of living a healthier life,” said Dr. Sehgal.

Posted 9/2/2010