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A PROCEDURE USED TO CLEAR BLOCKAGE IN HEART CAN NOW CLEAR BLOCKAGE TO THE BRAIN; SHADYSIDE HOSPITAL PHYSICIAN PERFORMS SUCCESSFUL ANGIOPLASTY ON THE CAROTID ARTERY

A PROCEDURE USED TO CLEAR BLOCKAGE IN HEART CAN NOW CLEAR BLOCKAGE TO
 THE BRAIN; SHADYSIDE HOSPITAL PHYSICIAN PERFORMS SUCCESSFUL
 ANGIOPLASTY ON THE CAROTID ARTERY
 PITTSBURGH, Feb. 10 /PRNewswire/ -- Dr. Mark Wholey, chief of Radiology at Shadyside Hospital has successfully performed a rare procedure which could provide stroke patients with an alternative to surgery, the hospital said today.
 Wholey recently performed balloon angioplasty -- commonly used in the heart -- on a blocked carotid artery which supplies blood to the brain. The successful angioplasty was undertaken to reduce the patient's chances for a major stroke.
 "The successful use of angioplasty in the carotid artery opens up a new area for investigation for use in potential stroke patients," said Wholey following the procedure. "Carotid disease and strokes are almost as common as coronary disease. If we can minimize the incidence of strokes by a simple angioplasty procedure, it would be less traumatic for the patient and a very excellent alternative to surgery."
 According to Wholey, approximately 75,000 enterectomies -- the surgical procedure to correct a blocked carotid arterty -- are performed each year in the United States. During surgery, the patient must be anesthetized while the carotid artery is split down the side, the blockage scraped out, and the artery sewn together. The patient then experiences some pain during recovery.
 With angioplasty, a narrow catheter was inserted through the groin and threaded directly to the affected carotid artery. The Wholey steerable wire -- developed by Dr. Mark Wholey -- was used to place the 5mm angioplasty balloon which was inflated, pushing the blockage back against the side of the artery, and freeing circulation.
 Two balloons were used for the procedure, first a smaller one similar to a coronary balloon to open the lesion, then a larger one to fully restore circulation. Balloons were opened only for 10 seconds instead of the longer periods of time used in the heart to reduce the risk of sudden clots (embolism).
 The total procedure took approximately 20 minutes. The patient experiences no pain because the arteries supplying the brain respond differently than those supplying the heart or legs. No major medications were perscribed, and the patient was discharged from the hospital in two days.
 According to Wholey, one advantage for the carotid artery in using this procedure is the large size of the vessel. Larger arteries resist reclogging better than the narrower arteries such as the coronary arteries and lower parts of the leg.
 The patient who underwent the procedure was suffering from transient ischemic attacks or "mini-strokes" and had lost speech and the ability to work, according to Wholey. The patient had also been experiencing periods of confusion or disorientation.
 Lawrence Wechsler, M.D., a neurologist at Shadyside Hospital and Michael Hahalyak, D.O., the referring physician, examined the paitient prior to the procedure and found the blockage to be too high in the neck for standard surgery. Dr. Neil Solomon, who examined the patient's diagnostic films, suggested that Wholey may be able to open the block.
 According to Wechsler, "This procedure has possible applications for patients who have had a minor stroke with severe narrowing of the carotid artery in a place that is surgically inaccessible, or for patients whose other health problems put them at too high a risk to undergo the standard procedure."
 "While surgically we can only go so high in the carotid artery, the balloon can go anywhere, giving us the ability to open blockages in less reachable areas," said Wholey.
 Mini-strokes of this types are often a precursor to a more severe stroke, said Wechsler. The brain can be endangered by a blocked carotid artery because pieces of the blockage can break off and clog circulation to the brain either stopping it or slowing it down causing a stroke.
 "The procedure went very well and I would consider it successful," said Wechsler. "While it is difficult to generalize how successful this procedure will become until it is tested in a larger group. The results with this patient were encouraging that it can be both safe and effective."
 Shadyside Hospital is a not-for-profit advanced teaching hospital founded in 1866. The hospital serves the Pittsburgh and tri-state region by providing personal, cost effective medical care, education and research; primary care for its immediate community; and specialized services for a referred population from the tri-state region and beyond.
 -0- 2/10/92
 /CONTACT: Nancy Lubinski of Shadyside Hospital, 412-623-6664/ CO: Shadyside Hospital ST: Pennsylvania IN: HEA SU:


JT -- PG004 -- 8194 02/10/92 10:16 EST
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Date:Feb 10, 1992
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