HACKENSACK, N.J., Dec. 19, 2017 /PRNewswire-USNewswire/ — Hackensack Meridian Health Hackensack University Medical Center is among the first in the tri-state region and the first in Bergen County, New Jersey to offer an innovative new treatment that prevents stroke in patients with blocked carotid arteries, the major blood vessels that deliver blood to the brain.  The minimally invasive procedure, called TransCarotid Artery Revascularization or TCAR, employs a new FDA-approved neuroprotection system that temporarily reverses blood flow in the artery during the procedure to prevent dangerous plaque from traveling to the brain and causing a stroke.

Prior to TCAR, the main treatment option for severe carotid artery disease was a surgical procedure called carotid endarterectomy. While this technique protects the brain during the procedure, the large incision leaves a visible and lengthy scar across the neck and carries risks of surgical complications including bleeding, infection, heart attack, and cranial nerve injuries that can cause issues with swallowing, speaking, and sensation in the face.

David O’Connor, MD, FACS, a vascular surgeon, Director of Vascular Research and Assistant Clinical Professor of Surgery at Hackensack University Medical Center, is among the first in the country to gain expertise with the TCAR procedure. “This new, cutting-edge procedure helps us prevent stroke in patients who are higher risk for traditional surgery, many of whom were previously considered untreatable,” said Dr. O’Connor. “With TCAR, we can perform a minimally-invasive procedure through a tiny incision in the lower neck that offers a safe alternative compared to traditional surgery, opening the door for many new patients to be safely and effectively treated.”

Dr. O’Connor performed the first TCAR procedure at Hackensack University Medical Center on Margaret Voloshin, a 64-year-old resident of Garfield.  Ms. Voloshin was an ideal patient for this procedure based on her medical history. She suffers from pulmonary and cardiac disease making her ineligible for carotid endarterectomy.

“This procedure was truly life-saving for me,” said Ms. Voloshin. “I suffered from several mini-strokes, and was at risk for suffering a major stroke. I was not eligible for any other surgical procedures to prevent future strokes. Thanks to Dr. O’Connor, the procedure was relatively easy and I was out of the hospital the next morning.”

Compared to traditional open surgery, the TCAR procedure is far less invasive providing significant benefits to the patients. “Patients recover more quickly, with less pain, and the risks of both minor and major complications are significantly decreased,” Dr. O’Connor added. “TCAR is a revolutionary treatment option for treating blocked carotid arteries.”

Every year, 15 million people worldwide suffer a stroke, also known as a “brain attack.” Nearly six million die and another five million are left permanently disabled. Stroke is the second leading cause of disability globally. Carotid artery disease is estimated to be the source of stroke in up to a third of cases and there are 400,000 new diagnoses of carotid artery disease made every year in the United States alone.

“TCAR is a groundbreaking new treatment option in the fight against stroke, and we are thrilled to be able to offer this service to some of our patients at risk for endarterectomy,” said Massimo M. Napolitano, MD, FACS, Chief of Vascular Surgery and Vice-Chairman of the Department of Surgery at Hackensack University Medical Center. “The cutting-edge advancements in vascular care are transforming stroke treatment and prevention options, further enhancing the quality of life for our patients. Dr. O’Connor and the entire vascular team continue to put Hackensack University Medical Center on the forefront of vascular care and stroke prevention.”

“TCAR is another example of thoughtful innovation and further highlights the Department of Surgery’s focus on patient safety as its top priority,” said Martin S. Karpeh Jr., M.D., chair of the Department of Surgery at Hackensack University Medical Center.

About Hackensack Meridian Health Hackensack University Medical Center  
Hackensack Meridian Health Hackensack University Medical Center, a 775-bed nonprofit teaching and research hospital located in Bergen County, NJ, is the largest provider of inpatient and outpatient services in the state. Founded in 1888 as the county’s first hospital, it is now part of one of the largest networks in the state comprised of 28,000 team members and more than 6,000 physicians. Hackensack University Medical Center was listed as the number one hospital in New Jersey in U.S. News & World Report’s 2016-17 Best Hospital rankings – maintaining its place atop the NJ rankings since the rating system was introduced. It was also named one of the top four New York Metro Area hospitals. Hackensack University Medical Center is one of only five major academic medical centers in the nation to receive Healthgrades America’s 50 Best Hospitals Award for five or more years in a row. Becker’s Hospital Review recognized Hackensack University Medical Center as one of the 100 Great Hospitals in America 2017. The medical center is one of the top 25 green hospitals in the country according to Practice Greenhealth, and received 23 Gold Seals of Approval™ by The Joint Commission – more than any other hospital in the country. It was the first hospital in New Jersey and second in the nation to become a Magnet® recognized hospital for nursing excellence; receiving its fifth consecutive designation in 2014. Hackensack University Medical Center has created an entire campus of award-winning care, including: the John Theurer Cancer Center; the Heart & Vascular Hospital; and the Sarkis and Siran Gabrellian Women’s and Children’s Pavilion, which houses the Joseph M. Sanzari Children’s Hospital and Donna A. Sanzari Women’s Hospital, which was designed with The Deirdre Imus Environmental Health Center and listed on the Green Guide’s list of Top 10 Green Hospitals in the U.S. Hackensack University Medical Center is the Hometown Hospital of the New York Giants and the New York Red Bulls and is Official Medical Services Provider to The Northern Trust PGA Golf Tournament. It remains committed to its community through fundraising and community events especially the Tackle Kids Cancer Campaign providing much needed research at the Children’s Cancer Institute housed at the Joseph M. Sanzari Children’s Hospital. To learn more, visit www.HackensackUMC.org.

About TCAR with the ENROUTE Transcarotid Neuroprotection and Stent System 
The ENROUTE® Transcarotid Neuroprotection (NPS) and Stent System from Silk Road Medical, Inc. are the first devices designed and FDA-approved specifically for TCAR.  The ENROUTE Transcarotid Stent is indicated for use in High Surgical Risk patients and is intended to be used in conjunction with the ENROUTE Transcarotid Neuroprotection System (NPS). The ENROUTE Transcarotid NPS is used to directly access the common carotid artery and initiate high rate temporary blood flow reversal to protect the brain from stroke while delivering and implanting the ENROUTE Transcarotid Stent.

SOURCE Hackensack Meridian Health

Related Links

http://www.HackensackUMC.org

Chronic total occlusion and previous interventions and amputations were among the predictors of major adverse events at 18 months in the LIBERTY 360° cohort, according to data presented at the Society for Vascular Surgery Vascular Annual Meeting.

As Cardiology Today’s Intervention previously reported, the LIBERTY 360° study of 1,204 patients with lower-extremity peripheral artery disease, stratified by Rutherford class 2 to 3 (n = 500; mean age, 70 years; 67% men), Rutherford class 4 to 5 (n = 589; mean age, 70 years; 62% men) and Rutherford class 6 (n = 100; mean age, 68 years; 73% men), is designed to evaluate procedural, long-term clinical and economic outcomes of endovascular interventions in patients with claudication or critical limb ischemia. Treating clinicians could use whichever devices they saw fit.

Researchers previously reported that at 18 months, 76.9% from the Rutherford class 2 to 3 group, 68.2% from the Rutherford class 4 to 5 group and 52.8% from the Rutherford class 6 group were free from major adverse events such as major amputation and reintervention.

At the Society for Vascular Surgery Vascular Annual Meeting, David O’Connor, MD, FACS, assistant professor of surgery and director of vascular research at Hackensack University Medical Center, presented predictors of major adverse events at 18 months.

In a multivariable model, he said the following factors independently predicted major adverse events at 18 months:

• CTO (HR = 1.78; 95% CI, 1.36-2.33);

• number of wounds on target limb at baseline (HR per 1-unit increase = 1.33; 95% CI, 1.2-1.49);

• previous peripheral vascular interventions for PAD (HR = 1.61; 95% CI, 1.25-2.08);

• number of target limb procedures in previous 3 years (HR per one-procedure increase = 1.09; 95% CI, 1.03-1.14);

• total treated lesion length (HR per 1-cm increase = 1.01; 95% CI, 1-1.02);

• previous above-ankle major amputation on non-target limb (HR = 1.78; 95% CI, 1.12-2.84); and

• history of MI (HR = 1.32; 95% CI, 1.02-1.71).

“When assessing long-term outcomes in PAD patients treated with endovascular devices, many traditional predictors are significant in an unadjusted model, yet when accounting for potential covariates, those associated with disease progression and previous treatments were most strongly correlated with 18-month [major adverse events],” O’Connor said during the presentation. – by Erik Swain

Reference:

O’Connor D, et al. S8: Scientific Session 8. Presented at: Society for Vascular Surgery Vascular Annual Meeting; June 20-23, 2018; Boston.

Disclosure: The study was funded by Cardiovascular Systems Inc. O’Connor reports he serves on an advisory board for Cardiovascular Systems Inc. and has served as an investigator for trials sponsored by Boston Scientific and Spectranetics.