WESLEY S. MOORE, M.D.
Practice limited to treatment of carotid artery disease and aortic aneurysm including the less invasive stent-graft repair.
I am pleased to announce a new clinical trial involving patients with carotid bifurcation disease that is being conducted by the Division of Vascular Surgery at UCLA. At the present time, the only CMS approved indications for carotid stent/angioplasty (CAS) are patients who are considered high risk for carotid endarterectomy (CEA) because of medical co-morbidities or anatomic considerations. We know from four recent prospective randomized clinical trials of average risk patients that CAS carries a significantly higher risk of peri-procedural stroke when compared to CEA. This is presumably due to thrombo-embolization from atherosclerotic plaque in spite of the use of distal embolic protection devices.
We are now participating in a clinical trial designed to test the safety and efficacy of a new approach to embolic protection using the concept of flow reversal during the placement and expansion of a stent. Flow reversal has the potential advantage over distal protection in that the lesion does not have to be crossed while anti-grade flow is present. In addition, since the flow-reversal device is placed in the cervical carotid artery, embolic protection and stent angioplasty can be performed without the necessity of dealing with anatomically diseased or disadvantaged aortic arches that must be encountered with a traditional trans-femoral approach. Clinical trials in Europe suggest a major advantage of this new technique. Based upon their data, the FDA has approved a clinical trial in centers in the United States. I have attached a diagram of the system with the steps involved with stent/angioplasty using flow reversal for your information.
Should you have a patient that you would like us to consider for this trial, please contact me or our study coordinator, Kathleen Land R.N. at 310-206-1115. We look forward to working with you.
Wesley S. Moore, M.D.
Professor and Chief, Emeritus
Division of Vascular Surgery, UCLA