Outcomes 2017 - Baylor Heart and Vascular Services FY2017 | Page 54

V Carotid Endarterectomy At Baylor Hamilton Heart and Vascular Hospital, vascular surgeons possess extensive experience helping diagnose and treat patients who may need surgical intervention for atherosclerotic plaque buildup in the carotid arteries, a potentially dangerous health condition. Plaque accumulation can block blood flow to the brain, or break into small particles leading to a transient ischemic attack, mini-stroke, or permanent, disabling stroke. The main treatment for atherosclerotic plaque of the cervical internal carotid artery is carotid endarterectomy (CEA), a procedure first described in the mid-1950s and used increasingly as a stroke prevention measure during the 1960s and 1970s. Carotid endarterectomy removes the inner lining of the carotid artery where plaque deposits are located, eliminating the source of a neurological event. Patients unable to undergo CEA for various medical reasons may benefit from another procedure, carotid angioplasty and stenting, to Carotid Endarterectomy open and cover the obstructing plaque. Vascular surgeons on the medical staff at Baylor Hamilton Heart and Vascular Hospital have been involved in years of research and clinical studies related to carotid stenting devices and techniques. DIAGNOSTIC TESTING 52 To diagnose carotid artery disease, Baylor Hamilton Heart and Vascular Hospital offers tests including carotid ultrasound, carotid angiography, and computed tomography angiography. Carotid ultrasound, also called sonography, shows vascular surgeons if plaque has narrowed a patient’s arteries and to what extent; a Doppler carotid ultrasound demonstrates how blood moves through the carotid arteries. In carotid angiography, an x-ray procedure, contrast dye is inserted into the patient’s vein, usually through the leg, and travels to the carotid arteries to highlight them in x-ray images. Computed tomography angiography, or CT angiography, takes x-ray pictures of the body from many angles and combines them to produce two- and three-dimensional images. CT angiography allows vascular surgeons to visualize the carotid arteries and may include the use of contrast dye. VASCULAR SURGERY VOLUMES 2,312 FY15 FY16 2,587 2,672 FY17 0 500 1000 1500 2000 2500 3000 Leaders in vascular surgery education, surgeons on the Dallas campus offer once a quarter video conferences to eight sites around the country. Special case studies are used to enhance other clinicians’ knowledge on vascular surgery topics. 1957 Jesse Thompson, MD, performed Dallas’ first carotid endarterectomy It became the standard for the next half century. In fiscal year 2017, more than 160 procedures involving the carotid artery including carotid endarterectomy and carotid stents occurred at Baylor Hamilton Heart and Vascular Hospital. “The vascular program at Baylor Dallas has long been considered the premier program. With the second oldest vascular surgery fellowship in the country, the program has historic roots with Jesse Thompson, MD, the founder of the vascular group and especially known for his pioneering work in carotid endarterectomy.” John F. Eidt, MD, RVT, RPVI, FACS Vice Chair - Vascular Surgery – Baylor Hamilton Heart and Vascular Hospital, Baylor University Medical Center