74 YEAR-OLD WITH 95 PERCENT BLOCKAGE IN CAROTID ARTERY UNDERGOES INNOVATIVE, NONSURGICAL TREATMENT AT SBUMC
Brooklyn father of three, grandfather of six, was not a surgical candidate
STONY BROOK, N.Y., October 30, 2007 - John Davenport's daughter, Kathy Culver, a pediatric critical care nurse practitioner, was at her wits' end. At 74 years old, her father, a retired manager of the A&P in Brooklyn, was losing neurological function, and a wide array of risk factors made him a high-risk candidate for surgical intervention. John has a body mass index that qualifies him as morbidly obese. He is diabetic, suffers obstructive sleep apnea, coronary artery disease and hypertension.
"Surgery was just not an option," said Kathy. "He would not survive."
On top of that, John's quality of life had deteriorated since January because of the neurological issues he was experiencing: a droop on the left side of his mouth, weakness and loss of balance, and memory loss. Kathy's mom, Eleanor, was frightened. Her husband was disappearing before her very eyes.
When John was diagnosed with 95 percent blockage in his carotid artery in June, Kathy's thoughts for her father shifted from concern to fear. He was at risk for a major, potentially life-threatening stroke. She sought nonsurgical solutions and learned about a clinical trial offered in the Heart Center at Stony Brook University Medical Center that sounded promising. Stony Brook is the only location in Suffolk County participating in a study that allows stenting of blocked carotid arteries to prevent stroke in patients who have not yet suffered a stroke (primary prevention). Dr. Allen Jeremias, Director of Vascular Medicine and Peripheral Intervention in the Division of Cardiovascular Medicine, the principle investigator, evaluated John, and determined after reviewing his MRI that he was a candidate for the procedure associated with the study.
Dr. Jeremias told Kathy that he could relieve the obstruction without surgery if her dad elected to participate in the CREATE PAS carotid stenting study.
"The study's primary objective is to confirm the safety and effectiveness of a newly approved carotid stent systems and embolic protection devices in the treatment of common and/or internal carotid artery stenosis," says Dr. Jeremias. "This study is specifically intended for patients who are at a high risk for stroke, and who also are at risk for complications during surgical removal of plaque from the carotid artery that has become narrowed or blocked."
John agreed and underwent the carotid stenting procedure on Friday, September 21, and was discharged from the Heart Center at Stony Brook the next day.
"The images say it all," said Dr. Jeremias. "When John came in he had 95 percent occlusion. There was a trickle of blood flowing through his major artery. When we placed the stent, the artery was wide open; the blood flowed beautifully."
"There was an immediate improvement in the color of his face," said Kathy. "Then, when dad got up, he realized he didn't have to hold on to furniture for balance, and didn't need his cane anymore."
John and Eleanor will return to Stony Brook this month so Dr. Jeremias can do a follow up study on John in the Heart Center, which will demonstrate if the artery continues to be clear of blockage.
"Stony Brook saved my life," said Kathy. "I've been a critical care nurse practitioner for 10 years, and a registered nurse in critical care for 32. I feel responsible for my dad's health. I knew what would happen if he had to go through surgery, and I feel like the Heart Center and Dr. Jeremias gave me my dad back."
About the Study
"Carotid Revascularization with ev3 Arterial Technology Evolution Post Approval Study" (CREATE PAS), is currently enrolling subjects who require treatment of the common and/or internal carotid artery and are at high risk for complications during endarterectomy. Enrollment will continue through 2008. The study is sponsored by ev3 Endovascular, Inc. Patients will be considered for enrollment if they are candidates for carotid stenting using a femoral arterial approach, are at least 18 years old, and if they meet at least one of the high surgical risk criteria in either the clinical or anatomical section. For more information contact Allen Jeremias, M.D., at 631-444-1060.