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Reversing blood flow to prevent strokes

Published: Jul. 1, 2020 at 8:30 AM EDT
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(07/01/2020) -- This year 140,000 people will die from a stroke. It happens when blood flow to the brain is blocked. A new procedure is opening up pathways and helping millions of people live longer, stroke-free.

In the next 40 seconds, someone will have a stroke.

Every four minutes someone dies.

It can be caused by a blockage in your heart, legs, or the main arteries in your neck.

Mahmoud Malas, MD, MHS, RPVI, FACS, Professor in Residence, Vice Chair of Surgery For Clinical Research and Chief, Division of Vascular and Endovascular Surgery at University of California San Diego, Health System explained to Ivanhoe, “The carotid arteries are the two main arteries that run in the neck and profuse the front of the brain.”

Traditional stenting uses a catheter to run a stent up from your arm or groin and can be risky.

“As we go in, we can break little pieces of plaque from the aorta near the heart and cause a stroke,” elaborated Dr. Malas.

That’s what UC San Diego vascular surgeon Mahmoud Malas feared would happen to Ricardo Levy after an ultrasound revealed plaque in his carotid artery.

Dr. Malas used a combination of procedures to lower the risk for Ricardo. First, he performed a transcarotid artery revascularization or TCAR.

“By making a small incision at the base of the neck, we directly can deliver the stent into the carotid artery,” clarified Dr. Malas.

Then he reversed the blood flow into the brain.

Dr. Malas illustrated, “When we are ready to deploy the stents, we clamp the carotid artery right here.”

“The blood will go from the other side of the carotid and get filtered through that filter right here, and then back into the femoral vein, so the patient doesn’t lose any blood. But essentially, no debris can go back up into the brain, and we are able to minimize that risk of stroke,” demonstrated Dr. Malas.

“This is probably one of the coolest things we do today in vascular surgery,” added Dr. Malas.

Ricardo thinks so too.

“There's not even a scar. Maybe with a microscope, you can find the scar,” shared Ricardo.

The flow reversal has been approved by the FDA.

Currently, it's used for patients who are at high risk for complications, including those who have at least 50 percent blockage of their carotid artery or other neurological symptoms.

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