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A new method of stroke prevention to be used at the Na Homolce Hospital for the first time worldwide
Cardiologists of the Na Homolce Hospital performed a unique surgery involving the implantation of micro-filters into both carotid arteries. This was done in an attempt to intercept possible thrombi. It is a stroke-preventive measure designed especially for patients with atrial fibrillation.
„This cardiac rhythm disorder may lead to a thrombus which may, in some cases, cause stroke. Indeed, the risk of stroke in patients with atrial fibrillation is five times higher than that in healthy population. A permanent micro-filter can mechanically catch the thrombus before it gets to brain arteries, thus preventing stroke. It is a relatively simple procedure that we trained for hard at the end of August last year in Israel“, said Professor Neužil, Senior Consultant of the Cardiology Department in the Na Homolce Hospital.
The procedure was performed for the first time in two stages: the first one on Friday March 2 and the second one a week later, i.e. yesterday. A total of four patients – two female and two male patients (average age of 67 years) – underwent the surgery these two days. In four out of five selected patients, a micro-filter was introduced into the second carotid artery a week later, in the fifth patient, the implantations will take place two weeks apart. These patients were selected for uncontrollable atrial fibrillation, high risk profile, contraindications of anticoagulation (dilution) treatment or very unstable clinical condition. Three of them have a history of stroke, one of the patients had six of these episodes. At the first stage, cardiologists implanted a micro-filter into the right carotid artery, at the second stage into the left carotid artery. The procedure was divided into two days a week or two weeks apart for safety reasons in accordance with the study protocol which was approved by the NHH Ethics Committee.
The introduction of a permanent microfilter into carotid arteries (vessels that bring blood to the brain) is performed under ultrasound guidance only (i.e. with no radiation burden) in local anesthesia. The operating cardiologist introduced the filter by means of a very thin needle through the skin. After the trigger is switched on, the filter is robotically advanced from the injector case and expands freely in the artery. The introduction proper into the carotid artery does not last longer than 30 seconds. The possibility to remove the filter immediately should the optimum position not be reached is an advantage. The filter may be removed as long as 24 hours after the procedure. The patient is discharged from the hospital after the follow-up examination performed the next day.
All the patients who have undergone the procedure are without any major complications. Microfilter implantation lasted only 15 minutes in average and patients did not feel any pain during the procedure.