The therapy, called carotid artery stenting, has been studied extensively and was approved for limited use by the FDA and insurers in March of 2005. The procedure is considered an equally effective treatment for patients compared to carotid artery surgery, while lowering the risk for adverse outcomes in patients considered high-risk for the surgical approach.

The standard operation, carotid endarterectomy, has been used since the 1950's to prevent stroke. It involves a surgical incision on the neck, opening the artery and peeling out blockage, then surgically closing the wound. Potential surgical complications include bleeding, wound infection, facial and vocal chord injury, peri-operative heart attack and rarely, stroke or death. In patients with significant pre-existing illness such as prior heart attack with heart failure, severe lung disease or a prior neck surgery or neck radiation treatment these surgical risks are amplified.

Stents on the other hand, prop open the artery to restore blood flow caused by blockages. This less invasive method allows the stent to be placed in the artery by using an X-ray machine and a catheter device. The patient is usually in the hospital less than 24 hours and has no surgical wound. "It is safer than traditional surgery for high-risk patients" said Dr. Merritt.

Recently, Medicare and insurers have allowed expanded use of the stent device to include patients without symptoms of stroke who have severe blockage. St. John's is able to offer the procedure by participating in a clinical trial that tracks patients for one year following the procedure. Candidates are people with at least an 80% blockage who are willing to be part of the trial and are considered high-risk for the traditional surgery.

"This is a new option for patients, especially those that may be considered too high risk for the open surgery and therefore would be excluded from the stroke prevention benefits of carotid artery treatment," Dr. Merritt said.

St. John's physicians have performed 20 to 25 of the less invasive carotid stent procedures and predict they will do another 50 to 100 over the next year. It is only going to grow in popularity among physicians and patients, said Dr. Merritt.

Since being the first in the region to perform open-heart surgery in 1972, St. John's has a history of first milestones in providing leading-edge cardiac and stroke care. Highlights include being one of the busiest cardiac catheterization labs in the state, the first in the region to offer drug-eluted stents and one of a few hospitals in the country to benchmark standards of stroke care.

St. John's led the way with cardiac rehabilitation more than 20 years ago and recently opened the area's first and only Women's Heart Center, dedicated to educating, screening and treating women for heart disease, the number one killer of women today.


For media information, contact St. John's Media Relations at 417-820-2426 or cscott@sprg.mercy.net.