NYM Is Only Hospital in Brooklyn to Offer FDA-Approved Artery Stent

Date: 12/5/2007

Studies show carotid artery stent is safer, more effective than invasive surgery for some patients.

Brooklyn, NY November 2007 – New York Methodist Hospital is among just a handful of medical centers in the New York area certified to perform a new interventional procedure designed to treat and prevent blockages in the carotid artery that can cause strokes. The technique, called carotid artery stenting, may be safer and more effective than invasive surgery for many patients, according to several new studies.

"Carotid artery stenting is a beneficial new treatment for patients with carotid artery disease, and particularly for those who are not good candidates for invasive surgery,  explains Dr. Marcus D''Ayala, MD Chief of Vascular Surgery at New York Methodist Hospital. "The irony is that medical problems like vascular disease and advanced age – the very conditions that make carotid artery surgery necessary to prevent strokes – are contraindications for surgical candidates,  adds Dr. D''Ayala, who specializes in carotid artery surgery and the new stenting procedure. "New data indicates that carotid artery stenting can be a lifesaver for these patients."

New York Methodist Hospital is a participating center in the SAPPHIRE WW Registry. Earlier results of the SAPPHIRE trial, in which patients were treated either with carotid artery stents or an invasive surgical procedure called endarterectomy, demonstrated that only 5.8% of the stent patients had strokes compared to 7.7% of those who had surgery. The risk of myocardial infarction was 2.5% in the stent patients versus 8.1% of those who had surgery. The mortality rate was 7% for the stent patients at one year compared to 12.9% of the surgery patients.

"These studies show us that stenting is a viable procedure that can help patients with carotid artery disease who are poor surgical candidates avoid the often-disabling and catastrophic consequences of a stroke,  Dr. D''Ayala concludes. He explains that the procedure, which is conducted under local anesthesia and/or sedation, involves using guided imagery to lead surgeons to areas in the carotid artery

where plaque and blockages are present, and insert small mesh stents to prop open the walls of the artery and keep them open. The device also includes a small filter that can catch debris and loose particles, further decreasing the chance of stroke. Other benefits of the stent procedure include a shorter hospital stay and recovery, the elimination of general anesthesia and related complications, and a drastic reduction in infection rates. "What''s more, because there is no incision, the cranial nerves are uninvolved in the stenting procedure, while the SAPPHIRE trial and other studies have shown cranial nerve damage incidents in anywhere from 4.8 percent to 9 percent of endarterectomy patients.

At least half of all American adults are at elevated risk for a stroke, according to the National Stroke Association, and stroke has already reached epidemic status in the U.S. According to the CDC, 700, 00 Americans suffer a stroke each year, and approximately 150, 00 Americans die each year due to stroke – making stroke the third leading cause of death in this country. It is also the leading cause of disability in the U.S., costing the healthcare system more than $63 billion annually, according to the American Stroke Association.

BIO:

Dr. Marcus D''Ayala, MD, is Chief of Vascular Surgery at New York Methodist Hospital, and Associate Professor of Clinical Surgery at Weill Medical College of Cornell University He received his doctoral degree from the University of Wisconsin at Madison in 1992. Dr. D''Ayala performed his surgical residency at the Albert Einstein College of Medicine/Montefiore Medical Center in the Bronx, and his Vascular Fellowship at The Mount Sinai Medical Center in New York. Dr D''Ayala is certified by the National Board of Medical Examiners and the American Board of Surgery, which awarded him certification in Vascular Surgery in 2000. Dr. D''Ayala was named to the 10th Edition Castle Connolly Guide''s "Top Doctors, New York Metropolitan Area" list, and has received awards for excellence in patient care, as well as for his peer-reviewed journal articles. Dr. D''Ayala is a member of The Society for Vascular Surgery, The International Society for Vascular Surgery, The Peripheral Vascular Surgical Society, New York Surgical Society, The New York Society for Vascular Surgery and Brooklyn Surgical Society.